THE  LIBRARY 

OF 

THE  UNIVERSITY 

OF  CALIFORNIA 

PRESENTED  BY 

PROF.  CHARLES  A.  KOFOID  AND 

MRS.  PRUDENCE  W.  KOFOID 


MEMOIR 


OF 


J  AME  S    JAC  KS  ON,  Jr 


MEMOIR 


OP 


JAMES   JACKSON,  Jr.  M.  D. 

WRITTEN  BY  HIS  FATHER, 


WITH 


EXTRACTS  FROM  HIS  LETTERS, 

AND 

REMINISCENCES  OF  HIM, 

BY  A  FELLOW  STUDENT. 

FOR  THE  WARREN  STREET  CHAPEL. 


The  Cross  and  the  Press  are  the  two  great  instruments  for  the  ciril- 
izatioa  of  the  human  race.  —  Lamartine. 


BOSTON: 
HILLIARD,    GRAY   &   CO 
1836. 


Entered  according  to  Act  of  Congress,  in  the  year  1836, 

Bt  John  L.  Emmons, 

In  the  Clerk's  Office  of  the  District  Court  of  Massachusetts. 


TuLtUe,  Weeks  &  Dennett Power  Press 17,  School  StreeC. 


\<^  i^y^-'xj 


i-ib-^ 


cKvU 


CONTENTS. 


Page. 

Memoir,  by  his  Father,      -  -  -  " 

Early  life  and  studies         -            -            -            -  3 
Letter  from  his  Father  to  him  while  in  New  York 

on  the  eve  of  his  departure  for  Europe    -  13 

Extract  from  his  answer               -            -            -  16 

Arrival  in  Paris            -            -            -            "  ^^ 

Connexion  with  M.  M.  Louis  and  Andral            -  25 

Letter  from  M.  Louis  to  his  Father     -            -  27 

Asiatic  Cholera      .            -            -            -            -  34 

His  feelings  and  labors  upon  this  occasion     -  35 

Visit  to  Great  Britain        -            -            -            -  40 

Return  to  Paris             -            -            -            "  ** 

His  labors  at  the  hospital  la  Pitie             -            -  47 

Society  for  Medical  Observation          .            -  49 

Departure  from  Paris         -            -            -            "  ?^ 

Note  from  M.  Louis  on  that  occasion             -  ib. 

Letter  to  his  Father           -            -            -            -  58 

Arrival  at  New  York  -            -            -            -  59 

Death           -            -                       ...  60 

Some  features  of  his  character             .            -  62 

Notes  to  the  Memoih. 

A,  some  reasons  why  a  medical  man  should  not  in 


n  ■  3^  it. 


CONTENTS. 


Page, 
this  country  devote  himself  entirely  to  the  merely 
scientific  pursuit  of  his  profession  -  -  -       79 

B,  Ram  Mohun  Roy  -  -  -  83 

C,  Louis  and  his  labors       -  -  -  -      84 
E,  Notice  of  Jackson,  published  in  Daily  Advertiser  99 


Extracts  from  Letters 

Oct.  28,  1831.     The  difficulties  of  auscultation 
Hotel  Dieu  and  La  Pitie 


Nov.  28,     " 
Dec.  1,      " 

Feb.  16,  1831. 
"     27,      " 


Diseases  of  the  Brain 
Emphysema  of  the  lungs  ;  case 
Louis  ;  his  method ;  Society 


107 
109 
114 
115 
116 
119 
125 


March  1,  1832.  Louis's  clinique  and  Andral's  elo- 
quence       _  .  -  -  - 
March  20, 1832. 
April  1;        " 

"     8, 

"    25,        " 
June  30,         " 


123 
129 
132 
136 
139 


July  10, 

August  19, 
Sept.  14, 
"        22, 


"       28, 
Oct.  1, 
Nov.  1, 
"     13^ 
"     24, 


Society  for  Medical  Observation 
Cholera  in  Paris 

do.     shall  he  quit  Paris  ? 

Havre,  on  way  to  London 

Liverpool.    Treatment  of  cholera  141 

Journey  through  England        -      143 

Edi  nburgh.    Treatment  of  cholera  149 

Suggestions  for  Boston  -      151 

Dublin.     Museum.     Ireland  152 

London.    Guy's  Hospital  Museum  156 

"  Hunterian  Museum         157 

Mr  Owen  -  -  -       158 

Bartholcmew's  Museum      -  159 

Hunterian  Museum       -  -      160 

Circulation  in  the  web  of  a  frog      161 

Paris.     Andral's  Eloquent  Lecture  163 

"         Louis's  laws  -  -  164 

"        Morbid  Anatomy,Chemistry  165 

Knowledge  of  disease,  &c.  166 

Doubts  -  -  167 

Observation         -  -      169 


CONTENTS.  XI 

Page 
Dec.  27,       "  "       Inflammation     -  -  174 

Jan.  16,  1833.         "       Study  of  Medicine  -      ib- 

•*    25,        "  "      Auscultation.     Observation    179 

Feb.  6,        "  "      Practice  of  Medicine     -  183 

April  5,       "  "      Louis's  accuracy     -  -     ib. 

June  6,        "  "      "  Superb"  case  -  -  186 

"    27      "  "      Feelings  in  regard  to  obser- 

vation   ------     189 

Dec.  9, 1832.  "      Letter  to  a  friend  -  191 

June  18,  1833.       »  «  .  .     198 

Reminiscences,  by  a  fellow  student  -  -  205 

Letter  from  Jackson  -  -  -  -    219 

Notes. 

1,  Letter  from  C.  C.  Emerson        -  -  -226 

2,  Jouffroy 228 


PREFACE. 

The  Teachers  of  the  Warren  Street  Chapel, 
have  determined  to  publish  from  time  to  time 
works  which  will  lead  to  a  more  elevated  stand- 
ard of  merit,  more  liberal  views  of  moral  and 
religious  truth,  and  at  the  same  time  procure  for 
themselves  funds  by  w^hich  they  may  be  able  to 
extend  still  farther  the  usefulness  of  their  institu- 
tion. With  these  views  they  present  this  volume 
to  the  public,  in  the  full  conviction  that  the  Memoir 
and  the  Letters  of  such  an  individual  as  he  was 
whose  life  is  portrayed  in  them,  will  be  perused 
with  interest  and  that  they  will  do  good.    - 

Should  our  means  be  sufficient  we  shall  issue 
as  soon  as  possible  another  volume, 

Boston,  Nov.  10,  1836. 


TO 

P.  CH.  A.  LOUIS,  M.  D., 

OF     PARIS  , 

Who  was  regarded  by  the  subject  of  this  Memoir  as  a 
second  father,  not  with  more  admiration  than  filial  respect 
and  affection  ;  —  and 

TO 

FRANCIS  BOOTT,  M.  D., 

OF     LONDON, 

Whose  brio^ht  mind  and  pure  and  elevated  virtues  inspired 
the  most  ardent  and  sincere  love  in  his  young  friend  ;  — 

The  two  men,  to  whom,  among  many,  he  felt  most  indebted 
whilst  in  Europe  ;  — 

With  the  respect  and  gratitude,  which  under  such  circum_ 
stances,  a  father  must  feel,  this  Memoir  is  respectfully  and 
afiectionately  dedicated  by 

JAMES  JACKSON. 

Boston,  April  15,  1835. 


JAMES    JACKSON,    JR. 


'/^^H^^^c^X/ 


MEMOIR. 


/s^6 


The  following  pages  contain  a  memoir  of  the 
life  of  my  late  son,  James  Jackson,  Jr.  M.  D., 
with  extracts  from  his  letters  and  a  selection 
from  the  medical  cases  collected  by  him,  princi- 
pally in  Paris.  I  have  been  induced  to  print 
these  cases  by  the  solicitation  of  those,  who 
knew  how  he  had  collected  them.  I  have  been 
induced  to  write  the  memoir  in  consequence  of 
the  sug-Dfestion  of  those  who  knew  something;  of 
him,  and  whose  opinions  I  respect.  In  some 
points  the  task  has  been  grateful  to  me ;  sad, 
though  it  may  seem,  for  a  father.  I  thank  God 
that  I  have  been  aMe  to  maintain  my  cheerful- 
ness and  to  attend  to  the  common  occupations  of 
life  since  the  deplorable  loss,  which  I  suffered  in 
his  departure  from  this  world.  But  every  hour 
has  he  been  in  my  mind.  In  every  occupation 
in  almost  every  conversation,  however  little  oth- 
1 


^      ^^T>'  could  see  the  connexjon,  ni^  .&  Deen 

A      tjcfore  me.    ^It  has  beerivji  beautiful  uniag-e   and 

has  not  checked  any  pleasure,   nor  even   any 

*^v      g^i^^V'  ^^  which  I  thought  that  he  could  have 

J  ''•:Fnder  a^y  circumstances  I  might  seem  an 
_^ improper  .person  to  give  his  history,  and  my 
«st§Ltemsnts  may  be  deemed  scarcely  worthy  of 
credit.  "Who  will  believe  that  I  shall  be  impar- 
tial ?  I  can  say  however  that  I  would  not  wil- 
lingly be  guilty  of  exaggeration,  if  it  were  only 
from  a  respect  to  the  love  of  truth,  which  formed 
the  most  distinguishing  trait  in  his  character. 
He  loved  me  as  few  sons  love  their  fathers.  Of 
this  I  have  had  ample  and  constant  proofs.  But 
he  loved  truth  better,  and  would  not  subscribe  to 
any  opinion  because  it  was  mine,  though  he  was 
quite  willing,  in  his  conduct,  to  submit  to  my 
direction  and  control. 

But,  if  I  draw  a  fancy  picture,  while  I  design 
to  paint  the  character  of  my  son,  if  that  presents 
a  young  man  who  devoted  his  time  most  assidu- 
ously to  the  acquisition  of  useful  knowledge, 
who  cultivated  at  the  same  time  his  best  moral 
affections  and  acted  from  the  highest  love  of  vir- 
tue, and  who  thereby  secured  the  friendship  of 
the  wise  and  good,  the  fiction  at  least  may  have 


JAMES    JACKSON,    JR.  3 

some  good  influence  on  the  young  and  inexpe- 
rienced. At  least  it  may  lead  them  to  reflect 
on  the  immutable  connexion  between  virtue  and 
happiness. 

The  subject  of  this  story  was  not  indeed  re- 
warded by  long  life.  But  in  this  age  will  it  be 
maintained  that  long  life  is  the  greatest  of  bles- 
sings ?  This  is  a  topic,  on  which  I  shall  not 
enlarge  ;  but  I  will  only  say  for  myself,  which  I 
do  most  sincerely,  that  I  would  not  have  added 
a  year  to  my  son's  life  by  an  habitual  and  allowed 
indulgence  in  a  single  vice. 

The  history  of  my  son's  life  is  very  simple 
and  it  may  be  told  very  briefly.  He  was  born 
on  the  15th  January,  1810,  w^as  graduated  at  the 
University  in  Cambridge  in  1828,  and  then  en- 
gaged in  the  study  of  medicine.  This  he  did 
under  my  direction  and  as  my  pupil.  He  con- 
tinued as  such  till  the  April  of  1831,  and  during 
this  time  he  attended  the  medical  lectures  of  our 
University  and  saw  the  practice  of  the  Massa- 
chusetts General  Hospital.  In  the  spring,  1831, 
he  went  to  Paris,  wdiere  he  arrived  in  May,  and 
remained  till  July,  1833,  except  during  a  visit  of 
six  months  to  Great  Britain  and  Ireland  in  the 
spring  and  summer  of  1832.     He  reached  home 


4  MEMOIR    OF 

at  the  end  of  the  summer,  1833,  and  was  grad- 
uated as  Doctor  of  Medicine  in  our  University 
in  February,  1834.  He  was  now  prepared  to 
engage  in  practice,  and  took  rooms  for  himself 
in  Franklin  Place.  He  was  thus  brought  to  the 
starting  place  of  active  life,  and  under  circum- 
stances the  most  flattering  and  the  most  grateful, 
when  he  was  arrested  in  his  course.  Exactly 
at  this  point  he  was  arrested.  His  arrangements 
being  made,  he  sent  an  advertisement  to  the 
public  papers,  which  appeared  on  the  5th  of 
March,  and  on  that  day  he  was  taken  sick  so 
as  to  lodge  at  my  house  instead  of  occupying  the 
rooms,  which  he  had  just  announced  as  his  res- 
idence. This  sickness  was  his  last,  and  he  died 
on  the  27th  of  the  same  month,  being  in  his  25th 
year. 

Thus  cut  off  before  he  had  yet  been  tried  in 
the  serious  business  of  life,  and  having  passed 
his  brief  course  without  encountering  any  of  the 
trials  to  which  many  men  are  subjected,  it  would 
seem  that  his  story  could  hardly  afford  any  details 
of  interest  except  to  his  own  family.  And  yet 
he  did  excite  an  interest  during  his  life  in  very 
many  friends,  abroad  as  well  as  at  home,  and 
that  of  the  warmest  kind  ;  and  his  loss  has  been 
deeply  mourned  by   those,  whom  I  never   saw, 


JAMES    JACKSON,    JR.  O 

and  to  whom  he  was  recommended  only  by  his 
own  conduct.  There  must  then  have  been  some- 
thing in  him  to  have  excited  this  interest,  which 
I  shall  call  deep  and  ardent,  disregarding  the 
imputation  to  which  I  subject  myself  of  a  blind 
partiality.  This'something  was  in  his  character. 
If  he  is  to  be  commemorated  it  should  be  by 
delineating  that  character ;  and  while  doing  this 
I  shall  be  led  to  detail,  though  it  may  not  be  in 
exact  order,  the  events  of  his  life  as  illustrating 
it.  Any  friend  in  pursuing  this  course  would 
be  thought  liable  to  run  into  eulogy  instead  of 
giving  a  true  description  of  the  subject  of  his 
discourse  ;  a  fond  father  must  certainly  be  sub- 
ject to  this  suspicion.  Those  who  know  the 
truth  in  this  case  must  decide  whether  this  sus- 
picion is  justified  by  what  follows.  I  may  how- 
ever premise  that  I  shall  not  attempt  to  write 
coldly,  while  I  shall  endeavor  to  keep  in  mind 
that  my  business  is  not  to  display  my  own  feel- 
ings toward  the  beloved  subject  of  my  discourse, 
but  to  draw  a  picture  of  one  whose  features  are 
more  perfectly  engraved  on  my  mind  than  on 
that  of  any  one  else. 

From  his  earliest  age  my  son  always  mani- 
fested  great  cheerfulness  of  temper  and  gaiety  of 
heart,  so  that  he  was  never  long  depressed  by 


6  MEMOIR    OF 

trouble  of  any  kind.  He  was  always  ready  to 
sympathize  with  those  about  him,  and  he  loved 
to  engage  their  sympathy  in  return.  He  was 
not  contented  without  constant  action,  except 
when  engaged  in  study  or  other  occupation. 
These  characteristics  are  common  enough  in 
boyhood,  and  did  not  distinguish  him  among  his 
fellows  at  that  stage  of  life.  It  was  by  myself 
only  perhaps  that  his  indomitable  gaiety  of  heart 
was  then  noticed ;  though  I  also  remarked,  very 
early,  that  his  mind  was  capable  of  being  engaged 
in  the  most  solemn  subjects.  From  these  char- 
acteristics he  was  often  boisterous  and  annoying 
to  those  about  him,  but  he  was  so  good-humored 
they  could  not  long  be  angry  with  him.  He 
had  very  little  ambition  to  gain  distinction,  or  to 
be  a  leader  among  his  comrades,  but  delighted 
to  join  in  their  sports  on  terms  of  equality,  as 
anxious  that  they  should  be  pleased  as  to  have 
his  share  of  the  sport.  He  was  agreeable  to  his 
young  friends  without  being  distinguished  among 
them.  His  schoolmaster  loved  hitn ;  but  had  to 
punish  him  continually  for  the  sin  of  laughing, 
of  which  he  could  not  break  him  however.  He 
would  strive  at  times  to  get  a  high  rank  in  his 
class  to  please  me,  for  he  always  loved  me  most 
ardently  ;  but  he  seemed  not  otherwise  to  value 


JAMES    JACKSON,    JR.  7 

the  distinction.  Once,  when  a  little  boy,  he  had 
kept  at  the  head  of  his  class  for  two  or  three 
days,  and  then  a  younger  boy  got  above  him.  I 
reproached  him  for  permitting  this.  But  he 
said,  with  great  naivete,  that  the  other  boy 
"  ought  to  be  at  the  head  sometimes."  I  hardly 
gave  him  credit  at  the  moment  for  this  generous 
wish  for  the  gratification  of  his  rival,  but  his 
companions  in  later  life  will  agree  with  me  in 
believing  that  it  was  the  result  of  that  interest 
in  the  happiness  of  others,  which  he  manifested 
more  and  more  strongly  as  long  as  he  lived. 

In  college  his  ready  sympathy  led  him  at  first 
into  the  company  of  those,  who  were  most  gay, 
and  for  a  few  months  he  joined  in  their  pleasures. 
At  the  end  of  six  months  the  excellent  president 
gave  me  warning  that  my  son  had  become  in- 
timate with  those,  whose  company  was  the  most 
dangerous.  This  would  have  caused  me  great 
distress  but  that,  happily,  my  son  had  recently 
given  me  the  same  information  and  had  told  me 
that  he  had  discovered  his  danger ;  in  fact,  as 
soon  as  he  perceived  the  vices  of  his  associates, 
he  no  longer  sympathized  with  them ;  he  had 
broken  with  them.  .  It  was  so ;  and  his  connex- 
ion was  never  afterwards  renewed  with  them, 
nor  with  those  who  were  like  them.     He  now 


8  MEMOIR    OF 

happily  formed  an  intimacy  with  one  who  en- 
couraged all  his  virtuous  aspirations,  and  he 
began  to  cultivate,  upon  principle,  a  purity  of 
heart,  of  which  the  fruits  were  forming  in  all  his 
subsequent  life.  He  was  not  led  into  habits,  nor 
into  any  feelings  of  austerity.  Gaiety  he  could 
not  dismiss ;  it  was  ever  springing  up  in  him. 
He  was  guilty  of  imprudences  like  others.  But 
he  constantly  studied  his  duty,  he  cultivated 
more  and  more  the  best  principles  of  action,  and 
from  year  to  year  his  standard  of  excellence  was 
placed  higher  and  higher.  He  never  attained  a 
distinguished  rank  in  his  class  by  an  exact  atten- 
tion to  his  collegiate  duties,  a  circumstance  which 
I  do  not  mention  in  commendation.  Yet  with- 
out my  knowledge,  until  long  afterwards,  he 
established  for  himself  certain  rules  of  action 
and  habits  of  industrious  study,  from  which  he 
seldom  deviated  subsequently,  and  was  really 
storing  his  mind  with  valuable  knowledge.  I 
was  not  aware  of  his  industry,  though  I  thought 
that  I  watched  him  closely,  till  he  had  left  the 
college.  He  did  not  tell  me  of  it,  though  he  was 
very  open  and  ingenuous  in  telling  me  his  feel- 
ings and  his  errors.  When  he  began  the  study 
of  medicine  under  my  eye,  he  gave  himself  to  it 
with  an  energy  and  industry  that  surprised  me. 


JAMES    JACKSON,    JR.  ^ 

I  thought  at  the  moment  that  he  Avas  resolved  to 
make  up  for  past  negligences,  but  that  his  zeal 
would  probably  soon  abate.  I  did  not  yet  under- 
stand him.  Subsequently  my  only  apprehension 
was  from  his  too  great  devotion  to  his  studies, 
which  constantly  went  on  increasing.  I  pre- 
sumed that  the  temptations  to  pleasure  in  Europe 
would  draw  him  off  from  laborious  study  quite 
enough ;  but  not  so  ;  there,  even  more  than  here, 
he  spent  his  strength,  without  reserve,  in  his 
professional  pursuits  ;  though  he  meant  to  keep 
himself  within  the  limits  of  safety.  The  only 
temptation,  which  he  could  not  at  all  resist,  was 
that  furnished  by  the  invaluable  opportunities, 
there  offered  to  him,  for  the  increase  of  useful 
knowledge. 

When  he  went  abroad  his  reading  on  profes- 
sional subjects  had  been  so  extensive  and  his 
habits  of  observation  so  well  formed,  that  I 
thought  him  fully  prepared  to  avail  himself  of 
the  advantages  he  might  derive  from  the  excellent 
schools  of  Paris,  London,  and  Edinburgh.  I 
dared  not  then  say  so  even  in  my  own  family, 
for  I  feared  the  evil  consequences  of  too  much 
praise ;  but  I  regarded  his  acquisitions  as  very 
extraordinary  for  a  student  of  his  standing,  and 
therefore  let  him  go  at  an  earlier  period  than 


10  MEMOIR    OF 

tliat  at  which  I  commonly  advise   young  men  to 
take  the  same  step.     Those  who  are  acquainted 
with  medical  literature  will  believe  that  I  did  not 
overrate  his  diligence  after  considering  the  fol- 
lowing statement.      Before    the   termination   of 
the  second  year  of  his  pupilage  he  went  through 
the  Epistles  of  Morgagni  on  the  seats  and  causes 
of  diseases,  as  translated  by  Alexander,  in  three 
thick   quarto  volumes.     He  took  notes  of  what 
he  read,  and  as  he  went  on  compared  with  it  the 
invaluable   work  of  Baillie  on  morbid  anatomy, 
another  quarto,  with  the  plates  accompanying  it. 
This  he  did  indeed  in  the  quiet  of  the  country, 
but  he  took  proper  time  for  exercise,  and  did  not 
seem  to  me  more  industrious  than  at  other  peri- 
ods.    He  however  completed  the  whole  in  seven 
weeks.     Nor  did  he  read  this  work,  as  a  task, 
without  possessing  himself  of  its  contents.     He 
read  it  with  great  interest ;  and  he  fixed  in  his 
mind  so  many  of  its  details,   that  by  the   aid  of 
his  short  notes  he  was  able  to  refer  to  it  after- 
wards.    Thus  I  find  in  his  early  autopsies  in 
Paris,  which  he  entered  in  his  common-place 
book,  many  references  in  the  margin  to  cases  in 
this  great  storehouse  of  post-mortem  researches. 
Indeed  I  have  not  been  acquainted  with  any  one, 
who  was   so  intimate  with  the   details  of  this 


JAI^IES    JACKSON,    JR.  11 

work,  as  he  was.  Immediately  after  this,  and 
before  his  second  year  of  medical  studies  was 
tenninated,  he  v^TOte  a  long  dissertation  on  pneu- 
monia, in  doing  which  he  consulted  all  the  wri- 
tings on  the  subject  which  he  could  get  at,  both 
those  expressly  on  it  and  those  which  embraced 
it  with  other  subjects  in  systematic  works.  This 
dissertation  gained  him  the  Boylston  medical 
prize  from  a  committee,  among  the  members  of 
which  was  Dr  AVare.  Dr  Ware  spoke  to  me  of 
this  work  at  the  time  in  terms  of  great  commen- 
dation, and  I  confess  that,  when  I  read  it,  I  was 
fearful  that  it  would  be  supposed  I  had  rendered 
assistance  in  the  preparation  of  it,  which  in  such 
a  case  would  have  been  improper.  But  in  fact 
I  had  only  pointed  out  the  sources  of  information 
and  had  made  some  general  remarks  on  the 
subject,  as  I  should  in  conversation  with  any 
pupil.  I  was  aware  that  he  was  writing  on  the 
subject,  but  thought  at  the  time  it  was  only  an 
exercise  as  a  member  of  the  Boylston  medical 
society,  not  a  dissertation  for  a  prize. 

I  have  stated  these  things  as  examples  of  his 
industry.  I  may  add,  that  in  the  period  of  his 
medical  studies,  before  he  went  to  Europe,  scarce- 
ly two  years  and  a  half,  if  I  deduct  the  time 
employed  on  journeys,  he  had  read  a  very  large 


12  MEMOIR    OF 

proportion  of  all  the  valuable  English  standard 
works  on  medicine,  and  very  many  of  the 
French,  frequently  and  carefully  consulting  older 
works  in  other  languages  when  referred  to,  espe- 
cially when  facts  were  concerned.  At  the  same 
time  he  had  engaged  as  fully  as  most  others  in 
dissection  in  its  proper  season ;  he  had  attended 
the  hospital  most  punctually  except  in  the  sum- 
mer season ;  he  had  seen  much  of  disease  else- 
where, particularly  at  the  House  of  Industry, 
where  Dr  Fisher  was  then  physician,  and  fre- 
quently invited  him  when  there  was  anything 
particularly  interesting  ;  and  he  took  notes  of 
lectures  and  of  everything  which  came  under 
his  observation,  especially  of  the  autopsies  which 
he  attended,  so  that  he  had  covered  twelve  hun- 
dred folio  pages  of  his  common-place  books, 
when  he  left  home. 

It  was  thus  prepared  he  went  to  Paris,  there 
to  take  care  of  himself  when  just  past  twentyone 
years  of  age.  Thus  far,  except  two  or  three 
journeys,  he  had  lived  in  a  limited  circle  under 
the  eyes  and  care  of  his  friends.  At  college, 
even,  he  resided  principally  in  a  private  family 
of  the  first  respectability,  and  of  the  greatest 
moral  worth,  where  he  had  been  treated  as  a 
child  and  a  friend,  and  had  been  allured  by  kind- 


JAMES    JACKSON,    JR.  13 

ness  to  submit  to  wholesome  restraints  and  to 
Me  friendly  warnings  of  wisdom  and  experience. 
I  could  not  dismiss  one  so  inexpressibly  dear  to 
me  without  anxiety,  though  satisfied  that  it  was 
wise  that  he  should  go.  The  following  extracts 
will  show  something  of  the  state  of  his  mind, 
and  of  my  own.  They  will  bring  before  the 
reader  the  true  feelings  and  principles  which 
then  reigned  in  his  heart,  and  if  I  may  write 
about  him  at  all,  I  see  not  why  I  may  not  pro- 
duce them. 


EXTRACT  FROM  BIY  LETTER  TO  HIM,  APRIL  9,  1831. 

"  I  look  forward  with  sanguine  hopes  of  ben- 
efit from  the  opportunities  you  will  have.  I  feel 
satisfied  that  you  will  not  omit  to  avail  yourself 
of  them.  It  is  this  hope  of  benefit  to  you  which 
reconciles  me  to  your  absence,  for  I  have  already 
begun  to  look  to  you  as  my  most  interesting 
companion  for  the  remainder  of  my  daj'^s.  As 
to  the  hazards  to  which  you  are  exposed,  I  cer- 
tainly do  not  disregard  them;  yet  I  shall  not 
allow  a  regard  to  them  to  make  me  unhappy. 
At  least,  I  think  so  now.  There  is  a  risk  of  life, 
—  and  it  would  indeed  alter  the  aspect  of  my 


N 


14 


MEMOIR    OF 


future  days,  if  I  did  not  hope  to  have  you  by  my 
side  and  to  leave  you  behind  me  in  this  world^ 
But  this  is  the  smallest  risk  by  far.     Whether 
we  pass  a  few  short  years  together  in  this  world 
is  comparatively  of  little  consequence.    Whether 
we  meet  in  a  better  world  is  of  immeasurable 
importance.     This  depends  on  ourselves;  —  on 
the   strict  regard    to  morality   which   we   both 
maintain;  —  a  morality  in  Dr  Holyoke's  sense, 
which  includes  piety,  —  a  regard  to  our  Maker, 
as  well  as  to  ourselves  and  fellow-men.     Now  I 
am  not  insensible  to  the   temptations,  to  which 
young  and  old  are  exposed  in  Paris  and  London. 
I  can  think  of  them  till  I  tremble.     But  my, 
trembling  is  stilled  by  the  confidence  I  place  in 
you.     This  confidence  is  sincere  and  strong.     It 
is  not  unlimited,  but  it  is  as  great  as  it  can  be  in 
any  young  man.     I  know  that  your  fondness  for 
society,  arising  from  the  best  feelings,  is  very 
strong ;  but  I  feel  assured  that  you  know  how  to 
control  it,  —  and  that  your  principles  are  strong 
and  of  the  best  kind.     I  shall  not  therefore  allow 
myself  to  be  anxious  ;  and  it  is  more  to  tell  you 
this  than  to  insinuate  any  cautions,  that  I  have 
been  led  into  this  long  statement  of  my  views 
and  feelings.     In  temptation,  I  think  you  will 
first  think  of  home,  —  and  then  cast  your  eyes 


JAMES    JACKSON,    JR.  15 

higher,  —  to  the  home  we  all  ultimately  hope 
for,  and  to  the  Father  who  is  better  than  any 
earthly  parent.  I  referred  to  the  dangers  of 
society ;  —  I  wish  to  add  that  among  men  of  the 
world,  and  I  may  say  such  gentlemen  as  a  trav- 
eller meets,  there  is  a  sort  of  presumption  con- 
veyed in  conversation,  that  no  one  feels  bound 
very  strictly  by  the  rules  of  morality.  Now  one 
need  not  turn  knight-errant,  nor  missionary,  to 
beat  down  the  obnoxious  principles  thus  indirectly 
maintained.  But,  on  the  other  hand,  I  have 
never  found  any  society,  in  which  I  needed  to 
remain,  in  which  a  gentleman  was  bound  to 
a^ent  to  such  principles,  —  or  in  which  he 
might  not  declare  his  dissent  from  them,  when 
he  was  compelled  to  speak  of  them  directly.  In 
short,  a  man  never  loses,  but  almost  always  gains 
with  the  worst  men,  by  pursuing  an  honorable 
and  virtuous  course.  The  share  of  reputation, 
which  you  have  yourself  gained,  while  leading 
a  quiet  and  you  may  almost  say,  a  secluded  life, 
shows  you  that  a  man  gains  reputation  fully  in 
proportion  to  his  merits.  Some  persons  must 
see  your  course,  —  and  by  them,  even  while 
they  do  not  think  of  doing  so,  it  is  published  and 
fixes  your  character.  Not  that  a  regard  to  char- 
acter is  the  highest  motive  to  action,  but  I  was 


16  MEMOIR    OF 

led  to  speak  of  it  in  another  view,  viz.  :  that  a 
regard  to  it  in  the  eyes  of  those  about  you,  need 
not  lead  you  to  make  sacrifices  to  their  vices  and 
follies." 


The  letter  from  which  the  foregoing  extract  is 
made,  reached  my  son  in  New  York,  on  his 
arrival  there,  after  sailing  upon  the  Hudson,  and 
visiting  the  Trenton  Falls.  In  his  reply,  of 
which  the  greater  part  follows,  he  refers  to  the 
scenes,  in  which  his  mind  had  been  delightfully 
engaged. 


"New  York,  April  15,  1831. 
'"  MY  DEAR  FATHER, 

"  My  heart  beats,  and  my  eyes  fill,  and  my 
hopes  are  brightened,  and  my  resolutions  are 
strengthened,  as  I  advance  in  reading  your  kind 
letter  of  aflfection  and  advice.  Be  assured  I  will 
not  neglect  the  opportunities  which  I  am  about 
to  enjoy.  My  constant  prayer  is  to  God,  that 
he  will  give  me  strength,  moral  and  mental,  to 
improve  them  to  the  utmost.  I  have  already, 
some  time  since,  said  to  you  that,  were  it  not 
that  I  may  with  every  reason  expect  to  be  in 


JAMES    JACKSON,    JR.  17 

your  society  and  under  your  guidance  again  on 
my  return,  I  would  on  no  account  visit  Europe. 
I  feel  and  know  that  my  opportunities  for  improve- 
ment during  any  two  years,  which  I  shall  be 
absent,  would  be  much  greater  at  home  than  any 
I  can  obtain  abroad;  —  but  both  have  their  pecu- 
liar advantages,  and  trusting  in  the  mercy  and 
providence  of  God,  who  has  already  poured  upon 
me  so  many  blessings,  I  feel  a  confident  hope 
that  I  may  enjoy  both  without  foregoing  either. 

"  You  next  speak,  my  dear  father,  of  the  temp- 
tations abroad  to  young  men.  I,  too,  can  and 
do  think,  and  have  oftentimes  thought  of  them, 
^till  I  tremble.  I  feel  myself  to  be  weak,  weaker 
than  I  should  be.  I  am  not  phlegmatic;  —  I 
have  not  yet  learned  to  be  master  of  myself ;  — 
I  am  yet,  too  often,  much  too  often,  the  slave  of 
circumstances.  I  feel  that  this  is  to  be  the  toil 
and  study  of  my  life,  to  become  master  of  myself. 
I  am  learning  each  day,  more  and  more,  that  it 
is  the  education  of  the  immortal  part,  which 
should  and  must  demand  man's  most  serious  and 
untiring  attention.  I  begin  to  feel  too  that  it  is 
his  highest  happiness  to  cultivate  it.  I  see  the 
difficulties  with  which  I  must  contend,  and  I  feel 
deeply  conscious  of  my  moral  weakness; — but 
again  I  feel  a  sort  of  confidence  in  remembering 
2 


18  MEMOIR    OF 

that  the   Creator  has  given  to  man  strength   to 
resist  all  moral  evil,  and  in  hoping   and  praying 
that  he  will  enable  me  to  exert  it.     The  future, 
Avith  all,  especially  with  a  young  man,  is  uncer- 
tain; —  but  for  all  that  is  important   it  is  in  our 
hands ;  —  an   awful   responsibility,   indeed,   but 
yet  ennobling  and  encouraging.     One  thought  is 
most  cheering,  —  we  may  depend  upon  it  with 
security,  —  in  the   right  conduct  of  the   future, 
we  have  the  certain  aid  and  assistance  of  our  all- 
powerful  and  benevolent  Father,  who  will  point 
us  to  the  right  path  and  safely  conduct  us  over 
it,  however  rugged,  if  we  will  but  open  our  eyes 
to  see,  and  our  hearts  to  accept,  instead  of  blindly  , 
refusing  his  kind  offers.     My  dear  father,  this 
is  no  affectation ;  —  it  is   no   unmeaning  rhap- 
sody ;  —  my  mind   for  some  time  has  been  be- 
coming more  and  more  convinced  of  the  essential 
importance  of  these  subjects,  and  I  promise  you 
the  last  week  has  not  been  spent  in  vain ;  —  not 
only  has  my  mind  been  improving ;  —  my  heart, 
too,  is  better  for  what  I  have  seen  ;  —  it  is  good 
for  me   to  have  been  the  spectator  of  these  ma- 
jestic works  of  the   Deity  in  the   natural  world 
around  us.     My  heart  has  been  warmed  with  a 
sense  of  his  benevolence,  and  my  mind  opened 
anew  and  more  strongly,  to  a  conviction  of  his 
power  and  greatness. 


JAMES    JACKSON,    JR.  19 

"  In  anticipating  my  future  career  in  life,  my 
mind  is  filled  with  what  ?  I  can  tell  you,  for  I 
have  spent  much  time  during  the  last  three 
months,  in  a  serious  consideration  of  the  subject^ 
and  feel  that  I  have  arrived  at  somewhat  more 
definite  views  than  I  had  previously  entertained. 
I  would  divide  all  the  objects  of  my  aim  and 
ejTorts  into  two  classes,  —  the  essentials  and  the 
desirables  ;  —  and  in  a  few  w^ords  they  are  these. 
Among  the  first,  are  a  moral  character,  in  the 
fullest  acceptation  of  the  term ;  or  in  other 
words  a  life  of  virtue,  so  spent  as  shall  be  accep- 
table to  God,  and  render  me  fit  to  enjoy  the 
blessings  of  the  virtuous ;  an  honorable  and 
useful  exercise  of  my  profession;  —  these  two 
will  perhaps  include  the  only  remaining  essential, 
viz.  such  a  situation  in  society,  as  to  property, 
respectability,  and  so  forth,  as  every  young  man 
brought  up,  as  I  have  been,  feels  it  his  duty  to 
except  and  provide  for. 

"  Among  the  second,  I  would  reckon  the  plea- 
sures of  social  life,  a  handsome  and  independent 
property,  and  a  high  professional  reputation. 
The  time  has  been,  and  that  not  very  long  since, 
when  I  looked  upon  this  last  as  the  most  impor- 
tant of  all.  But  I  am  now  wiser.  I  have  not 
ceased  to  value  this  abstractedly  as  much  as 


20  MEMOIR    OF 

before ;  but  its  relative  place  among  the  objects 
of  my  desire   is   cliang-ed,  —  I   trust  irrevocably 
changed. 

"  One  word  more  on  this  subject,  and  I  have 
done.  You  say  it  is  rather  to  express  your 
confidence  in  my  principles,  than  to  insinuate 
any  cautions,  that  you  have  written  me  so  fully 
on  this  subject.  Trust  not  too  much  in  my 
principles.  At  this  moment  they  are  as  firm 
and  as  virtuous  as  I  could  wish;  but  I  have  told 
you  that  I  am  weak,  and  have  yet  to  learn  the 
severe  lesson  of  self-denial.  For  your  own 
comfort  and  happiness  believe  me  strong  if  you 
will;  but  for  my  good,  believe  me  weak.  It  is 
my  sincere  wish  and  desire,  I  may  almost  say 
command,  (for  in  such  matters  the  child  may 
command  the  parent,)  that  you  will  often  remind 
nae  in  your  letters  of  the  temptations  to  which  I 
am  exposed,  and  the  incentives  to  avoid  them. 
Do  not  think  that  I  am  writing  words  which 
mean  nothing.  It  had  been  my  intention  for 
some  weeks  past  to  write  you,  before  I  left  the 
country,  on  this  very  subject ;  to  request  your 
direct  and  constant  aid  in  the  preservation  and 
improvement  of  my  moral  character.  I  hope 
that  you  will  read  and  understand  this  request 
literally ;  as   much  so  as  any  I  ever  made  for  a 


JAMES    JACKSON,    JR.  21 

book  to  improve  my  mind,  or  a  dollar  to  clothe 
my  body.  One  duty  yet  remains,  —  a  cheerful 
and  a  pleasant  one,  and  yet  one  which  I  can 
perform  but  too  inadequately  ;  —  it  is  to  express 
my  gratitude  to  you  ;  to  express  to  you  all  that 
I  feel  would  be  impossible ;  —  perhaps  also  it 
would  be  unnecessary,  as  you  must  know  it 
already.  It  might  have  been  expressed  more 
fully,  and  most  becomingly  in  the  actions  of  my 
past  life  ;  but  it  has  not  been.  No  mode  is  now 
left  me,  but  by  words  and  my  future  conduct. 
No  words  that  I  can  use,  can  ever  exhibit  to  you 
my  real  feelings ;  and  for  my  future  conduct  I 
fear,  yet  hope.  The  duties  of  a  parent  to  his 
child,  which  your  approving  conscience  must 
tell  you  in  more  audible  tones  than  I  can  utter, 
have  been  by  you  most  strictly  exercised,  call 
for  a  correspondent  gratitude  from  the  child, 
none  the  less  because  they  are  the  duties  of  his 
parent.  But  in  my  case,  there  is  something 
more  than  this.  Though  I  love  to  dwell  upon 
the  relation,  which  exists  between  us,  and  the 
circumstances  and  scenes  and  events,  which  have 
arisen  from  that  relation ;  yet  I  have  sometimes 
taken  another  view  of  the  subject.  I  have  con- 
sidered the  relation  of  parent  and  child  as  adven- 
titious or  accidental ;  —  I  have  looked  upon  you 


22  MEMOIR    OF 

and  myself  as  two  beings  whom  God  had  placed 
upon  this  earth,  and  whom  accident  had  brought 
together ;  I  have  then  thought  of  how  much  I 
was  indebted  to  you  for  all  the  principles  and 
knowledge  and  powers  that  I  possess  ;  —  but, 
my  dear  father,  I  will  stop.  You  see  what  is  in 
my  mind,  —  I  have  been  writing  you,  till  I  am 
getting  too  much  excited; — but  it  is  a  holy 
excitement,  and  will  do  me  good.  My  prayer  is 
to  God,  that  we  may  meet  again  in  this  world, — 
but  I  know  it  is  uncertain,  —  my  prayer  and 
efforts  too  are  and  shall  be,  that  my  life  may  be 
so  spent  as  to  meet  you  in  another  world,  if  not 
in  this,  which  may  God  in  his  infinite  mercy 
grant." 


It  is  easy  for  a  young  man  to  make  promises 
in  any  situation.  We  all  know  how  uncertain 
must  be  the  strength  of  his  resolution  when 
brought  to  trial.  I  certainly  should  not  have 
given  these  extracts,  if  I  did  not  believe  that  my 
son's  conduct  abroad  was  in  full  accordance  with 
the  promises  implied  in  them.  That  he  was 
always  wise  and  discreet  is  not  to  be  presumed. 
But,  if  all  who  knew  him  did  not  combine  to 


JAMES    JACKSON,    JR.  23 

deceive  me,  and  if,  also,  evidences  of  everj^  kind, 
which  I  could  examine,  were  not  fallacious,  his 
life  was  such,  when  out  of  my  sight,  as  it  had 
been  at  home ;  —  marked  by  moral  purity,  as 
well  as  by  incessant  industry.  The  abundant 
testimonials  of  his  industry  which  I  now  possess, 
specimens  of  which  are  in  the  following  pages, 
show  that  he  had  not  time  to  engage  in  those 
pernicious  indulgences  which  too  often  engross 
young  men  in  the  cities  of  Europe.  Indeed,  I 
would  not  intimate  that  he  was  singular  in  this 
respect.  I  gladly  avail  myself  of  the  occasion 
to  state  that  the  medical  students  from  this 
country,  with  very  rare  exceptions,  are  too  much 
occupied  with  their  professional  studies,  when 
in  Paris  or  London,  to  allow  much  time  to  the 
ruinous  pleasures  of  those  great  cities.  This 
may  perhaps  be  fairly  attributed  to  the  very  in- 
teresting character  of  those  studies. 

In  Paris  my  son  attended  principally  in  three 
hospitals,  viz. ;  La  Pitie,  St  Louis,  and  that  for 
sick  children,  (Hopital  des  Enfans  Malades.) 
In  the  first  of  these  he  saw  the  practice  of  M. 
Louis  and  M.  Andral,  and  heard  their  clinical 
lectures.  It  was  here  he  spent  most  of  his  time. 
In  the  second,  (St  Louis,)  he  attended  to  diseases 
of  the  skin  and  to  the   lectures  of  M.  Biett.     It 


24  MEMOIR    OF 

was  not  possible  for  him  to  give  time  for  a  fre- 
quent attendance  at  the  Hopital  des  Enfans 
Malades,  at  the  regular  hours,  without  omitting 
his  visits  at  La  Pitie.  He  was,  however,  so 
fortunate  as  to  obtain  permission  to  go  with  the 
interne,  or  house-pupil  of  that  hospital  in  his 
evening  visit.  He  was  thus  able,  no  other  pupil 
being  present,  to  examine  more  minutely  the 
numerous  cases  there  collected,  than  he  could 
have  done  in  any  other  way. 

The  liberality  of  the  French  government,  for 
it  is  by  the  national  government  that  the  hospi- 
tals are  maintained,  permits  foreigners  to  join 
their  own  pupils  in  attendance  on  their  hospitals 
without  any  fee.  The  liberal  feelings  of  the 
physicians  and  surgeons  of  those  hospitals  lead 
them  in  like  manner  to  give  instruction  to  all, 
who  will  attend  to  it,  without  any  pecuniary 
reward.  Of  the  privileges  thus  granted,  my  son 
partook  with  others.  He  had  not  any  special 
introduction  to  the  medical  gentlemen  on  whom 
he  attended.  But  he  received  from  them  not 
merely  favors,  but  such  substantial  services,  that 
I  am  bound  to  acknowledge  them  in  giving  this 
account  of  his  life.  I  mean,  however,  also  to 
adduce  the  services  thus  rendered  him,  as  the 
evidence  of  impartial  witnesses  in  proof  of  his 


JAMES    JACKSON,    JR.  25 

merit  as  their  pupil.  I  refer  particularly  to 
M.  Louis  and  M.  Andral.  By  the  latter  he  was 
treated  not  only  with  civilities,  to  which  a  com- 
mon stranofer  could  have  no  claim,  but  he  was 
indulged  in  the  favor  of  free  intercourse  at  once 
most  flattering  and  most  useful  from  such  a 
source.  I  can  scarcely  describe  with  how  much 
reverence  for  the  genius  of  this  eloquent  profes- 
sor, and  with  how  much  gratitude  these  favors 
were  received.  By  the  former,  M.  Louis,  he 
was  distinguished  so  peculiarly,  that  I  shall  take 
the  liberty  to  print  two  of  M.  Louis's  letters  to 
me,  lest  I  be  suspected  of  exaggeration.  There 
grew  up  between  them  a  friendship  of  no  com- 
mon kind.  M.  Louis  treated  him  with  as  much 
kindness  and  confidence  as  he  could  have  shown 
to  a  son ;  and  James  felt  toward  him  an  affection 
second  only  to  that  which  he  experienced  toward 
myself. 

The  acquaintance  commenced  by  very  flatter- 
ing attentions  from  M.  Louis,  to  his  young  pupil, 
at  a  period,  when  even  his  name  was  probably 
unknown  to  his  master.  This  gave  my  son 
confidence  in  addressing  him.  Subsequently 
with  two  excellent  friends  from  Philadelphia,  he 
requested  from  M.  Louis,  private  instructions  on 
auscultation  and  percussion.     They  offered  com- 


26  MEMOIR    OF 

pensation  for  the  time  and  trouble,  which  he 
would  bestow  on  them.  The  compensation  was 
not  such  as  could  have  been  an  inducement  to 
M.  Louis,  yet  he  complied  instantly  with  their 
request.  They  had  not  dared  to  promise  them- 
selves this  success,  and  had  almost  feared  that 
he  would  regard  them  as  too  presumptuous. 
They  were  transported  with  the  prospect  before 
them,  and  still  more  with  the  excellent  instruc- 
tion which  they  obtained  in  consequence  of  it. 
Soon  after  this,  the  epidemic  cholera  appeared 
in  Paris.  The  part  which  my  son  took  at  this 
time,  I  shall  state  more  distinctly  by  itself;  but 
at  present  I  refer  to  this  period  as  the  time,  in 
which  the  acquaintance  of  my  son  wdth  both  his 
great  masters,  became  more  intimate.  When 
he  left  Paris,  after  having  studied  this  disease, 
at  the  end  of  April,  1832,  M.  Louis  manifested 
a  regard  for  him  in  terms  the  most  grateful  and 
most  flattering.  Venerating  him,  as  my  son 
now  did,  his  affectionate  heart  knew  not  how  to 
respond  to  so  much  kindness.  On  his  return  to 
Paris,  in  the  following  autumn,  he  at  once  was 
admitted  to  the  full  friendship  of  his  master, 
and,  while  he  remained  with  him,  their  inter- 
course was  of  the  most  confidential  character ; 
and  to  the  pupil  was  most  instructive. 


JAJIES    JACKSON,    JR.  27 


I  must  now  be  permitted  to  give  the  letters 
before  mentioned,  to  show  that  I  have  not  exag- 
gerated the  favorable  opinion  of  M.  Louis  toward 
my  son. 


TRANSLATION     OF     LETTERS     FROM     BI. 
LOUISTO     DR     JACKSON. 

SIR,    MY   RESPECTED    BROTHER, 

I  have  received  with  gratitude  the  letter  you 
did  me  the  honor  to  write  me  in  regard  to  your 
son  and  his  memoir  upon  cholera.  I  give  you 
special  and  hearty  thanks  for  having  afforded 
me  so  good  an  occasion  to  speak  of  one,  toward 
whom  I  entertain  sentiments  of  real  friendship 
as  well  as  of  esteem. 

It  did  not  require  much  time  for  me  to  appre- 
ciate fully  the  sagacity  and  talent,  which  your 
son  possesses,  in  the  observation  of  nature.  I 
had  remarked  these  characteristics  in  him,  before 
I  knew  who  he  was.  Soon  afterwards,  learning 
that  he  would  ere  long  return  to  Boston,  I 
pointed  out  to  him  the  advantage  it  would  be  for 
science  and  for  himself,  if  he  would  devote  sev- 
eral years  exclusively  to  the  observation  of  dis- 


28 


MEMOIR    OF 


eases.     I  now  retain  the  same   opinion  and  am 
strengthened    in    it ;    for   the    more    I   become 
acquainted  with,   and    the    more  I  notice   him 
applying-  himself  to  observation,  the  more  am  I 
persuaded  that  he  is  fitted   to  render  real  service 
to  science,  —  to  promote   its  progress.      I  find 
that  he  would  be  well  pleased  to  follow  for  a 
certain  period  the  vocation,  for  which  nature  has 
fitted  him  ;  but  he  has   stated  to  me   that  there 
are  many   difficulties,  which  would  prevent  his 
devoting  himself  exclusively  to   observation  for 
several  j^ears.      But   can    these    difficulties   be 
insurmountable  ?     Must  we  compel  ourselves  to 
believe  that  a  man,  w^hom  nature  has  peculiarly 
qualified  for  observation,  cannot  be  permitted  to 
exercise  the  peculiar  talents  bestowed  on  him. 
For  my  own  part  I  cannot  admit  the  belief;  I 
hope  and  trust  that  the  difficulties,  of  which  he 
has  spoken,  will  disappear. 

Let  us  suppose  that  he  should  pass  four  more 
years  without  engaging  in  the  practice  of  medi- 
cine, what  a  mass  of  positive  knowledge  will  he 
have  acquired !  How  many  important  results 
will  he  have  been  able  to  publish  to  the  world 
during  that  period  !  After  that  he  must  neces- 
sarily become  one  of  the  bright  lights  of  his 
country ;  others  will  resort  to  him  for  instruction, 


JAMES   JACKSON,    JR.  29 

and  he  will  be  able  to  impart  it  with  distin- 
guished -honor  to  himself.  If  all  these  things  be 
duly  weighed,  it  will  appear  that  he  will  soon 
redeem  the  four  years,  which  men  of  superficial 
views  will  believe  him  to  have  lost. 

It  is  with  the  utmost  seriousness,  sir,  that  I 
write  to  you  thus.  It  would  not  be  without  the 
deepest  conviction  of  the  advantages  of  the  plan 
I  propose,  that  I  should  offer  my  advice  on  a 
subject,  on  which  I  have  not  been  consulted.  It 
is  not  for  the  sake  of  making  to  a  parent  some 
grateful  remarks  about  his  son,  that  I  have 
pointed  out  to  you  how  much  may,  in  my  opin- 
ion, be  hoped  from  the  talents  for  observation, 
which  belong  to  Mr  Jackson;  but  simply  to 
render  homage  to  truth.  Excuse  me  then  for 
the  step  I  have  ventured  to  take,  and  believe 
that,  if  I  had  not  felt  that  I  had  in  this  case  a 
duty  to  fulfil,  I  should  not  have  offered  to  you 
my  advice,  nor  addressed  to  you  my  petition ; 
for  it  is  rather  a  petition  I  have  addressed  to  you, 
than  advice  that  I  have  given  you.  How  could 
I  venture  to  do  the  latter? 

Nevertheless  in  reading  over  my  letter,  it 
seems  to  me  to  betray  the  tone  of  an  advocate 
who  is  pleading  a  cause  ;  and  I  would  willingly 
begin  it  anew,  were  I  not  afraid  that   from  my 


30  MEMOIR    OF 

deep  conviction  of  the  truth  of  what  I  have 
stated,  I  should  relapse  into  the  same  fault. 
Accept  it  then,  sir,  such  as  it  is,  with  indulgence, 
and  believe  that  no  one  here  is  more  sincerely 
attached  to  your  son,  or  entertains  for  him  a 
higher  esteem  than  myself.  Above^  all,  listen  to 
the  suggestions,  which  I  have  ventured  to  make ; 
and  may  my  wishes  that  your  son  may  devote 
himself  exclusively  to  observation  be  ultimately 
realized ;  for  it  is  to  that  point  I  constantly 
return. 

I  conclude  by   renewing  to  you   my  thanks, 
and  beg  you  to  be  assured  of  the  sentiments,  &c. 

(Signed,)  Louis, 

Parts,  October  28,  1832. 


SIR,    MY    RESPECTED    BROTHER, 

I  thank  you  most  sincerely  for  your  last 
letter  and  particularly  for  the  details  into  which 
you  were  kind  enough  to  enter  with  regard  to 
your  son.  Nothing  certainly  could  be  more 
grateful  to  my  feelings  ;  for  it  is  almost  a  mark 
of  affection  for  myself,  and  I  feel  almost  worthy 
of  it  from  the  strength  of  that,  which  I  bear  to 
your  excellent  son.  He  will  soon  leave  us  ;  but 
his  name  will  long  be  mentioned  among  us,  and 


JAMES    JACKSON,    JR.  31 


I  hope  that  the  ocean,  which  is  to  separate  us, 
will  not  be  a  complete  barrier  to  our  intercourse. 

I  feel  more  than  any  one  else  how  much  you 
must  long  to  see  as  soon  as  possible  a  son,  whose 
profession  is  the  same  as  your  own,  and  with 
whom  it  will  be  so  delightful  to  you  to  converse 
respecting  it.  Indeed,  I  never  thought  of  induc- 
ing you  to  leave  him  Avith  us  in  Europe  for  four 
or  five  years.  I  love  in  Mr  Jackson  the  man 
and  the  physician ;  but  he  is  a  son,  and  you  are 
a  father ;  and  though  I  have  never  known  the 
delights  of  paternal  affection,  I  should  not  have 
regarded  as  possible  the  sacrifice  which  you 
understood  me  to  propose  to  you.  My  only  wish 
was  that  you  should  allow  your  son  to  devote 
himself  exclusively  to  observation,  for  several 
years  in  Boston.  I  recommended  this  to  you, 
because  no  one  is  more  capable  than  he  is  of 
cultivating  science  and  consequently  of  promoting 
the  progress  of  practice.  For  what  is  practice 
but  science  brought  into  daily  use  ? 

Think  for  a  moment,  sir,  of  the  situation  in 
which  we  physicians  are  placed.  We  have  no 
legislative  chambers  to  enact  laws  for  us.  We 
are  our  own  lawgivers ;  or  rather  we  must  dis- 
cover the  laws,  on  which  our  profession  rests. 
We  must  discover  them  and  not  invent  them ; 


32  MEMOIR    OF 

for  the  laws  of  nature  are  not  to  be  invented. 
And  who  is  to  discover  these  laws  ?  Who 
should  be  a  diligent  observer  of  nature  for  this 
purpose,  if  not  the  son  of  a  physician,  who  has 
himself  experienced  the  difficulties  of  the  obser- 
vation of  disease,  who  knows  how  few  minds 
are  fitted  for  it,  and  how  few  have  at  once  the 
talents  and  inclination  requisite  for  the  task? 
The  inclination  especially  ;  for  this  requires  that 
the  observer  should  possess  a  thorough  regard 
for  truth,  and  a  certain  elevation  of  mind,  or 
rather  of  character,  which  we  rarely  meet  with. 
All  this  is  united  in  your  son.  You  ought,  for 
in  my  opinion  it  is  a  duty,  you  ought  to  conse- 
crate him  for  a  few  years  to  science.  This,  sir, 
is  my  conviction,  and  I  hope  it  will  be  yours 
also.  I  know  very  well  that  every  one  will  not 
be  of  the  same  opinion ;  but  what  matters  it,  if 
it  be  yours  ;  if  you  look  upon  a  physician,  as  I 
do,  as  holding  a  sacred  office,  which  demands 
greater  sacrifices  than  are  to  be  made  in  any 
other  profession. 

Believe  me  that  I  do  not  forget  in  all  this  the 
force  of  established  usages.  I  think  of  all  this  ; 
but  I  am  none  the  less  convinced  that  Mr  Jack- 
son, entering  into  practice  after  three  or  four 
years,  with  the  esteem  of  all  his  professional 


JAMES    JACKSON,    JR.  33 

brethren,  and  surrounded  as  it  were  with  their 
respect,  will  very  rapidly  regain  all  which  he 
may  have  sacrificed  and  much  more.^  At  all 
events  my  best  v/ishes  and  those  of  all  his 
friends  here,  will  follow  him,  whatever  may  be 
his  course ;  and  I  shall  always  esteem  myself 
happy  in  having  knowni  him.  Permit  me,  sir, 
to  assure  you  of  this,  and  of  the  sentiments  of 
respect  and  affection,  with  which  I  am,  &c. 

(Signed,)  Louis. 

Paris,  March  22, 1833. 


To  the  foregoing  letters,  I  might  add  others, 
not  only  from  M.  Louis,  but  from  other  gentle- 
men in  Europe,  addressed  to  me  after  my  son's 
death.  But,  while  I  am  extremely  grateful  for 
the  kind  sjnupathy  they  manifest  toward  me, 
and  have  felt  assured  by  them,  that  my  partiality 
has  not  led  me  to  a  very  extravagant  estimate  of 
the  loss  I  have  suffered,  I  cannot  think  it  neces- 
sary to  add  any  further  testimony  to  that  which 
I  have  given  above. 

The  period  of  the  epidemic  cholera  in  Paris 

*  See  note  A. 


34  ME3I0IR    OF 

was  one  of  the  greatest  interest  and  of  the 
greatest  anxiety  to  the  subject  of  this  memoir. 
Until  the  end  of  the  winter  1831-2,  the  accounts 
which  we  had  received  in  this  country  of  the 
cholera  in  Europe,  were  of  the  most  alarming 
character.  We  knew  that,  arising  many  years 
previously  in  tlie  hot  climates  of  Asia,  this  deadly 
malady  had  passed  in  a  northwest  direction  into 
the  coldest  regions  of  Europe,  and  was  thence 
extending  itself  over  that  quarter  of  the  globe. 
Why  it  thus  spread,  and  whether  it  was  propa- 
gated by  contagion,  many  persons  were  ready  to 
decide  upon  general  principles  ;  but  precise  facts, 
on  which  to  form  a  decision,  were  not  yet  fur- 
nished. One  thing  was  certain,  that  it  affected 
great  numbers,  wherever  it  went,  and  proved 
fatal  to  a  large  proportion  of  those  affected.  Re- 
garding my  son  as  comparatively  without  friends 
in  a  foreign  country,  not  then  knowing  the  kind 
feelings  already  entertained  for  him  by  those 
most  capable  of  taking  care  of  him,  I  wrote  to 
him  urgently  to  fly  before  this  plague,  and  even 
to  leave  Europe,  should  the  disease  invade  at 
once  France  and  Great  Britain.  Such  letters, 
and  such  only  had  he  received  on  this  subject, 
when  the  disease  appeared  in  Paris,  on  the  last 
days  of  March.     It  had  already  been  introduced 


JAJIES    JACKSON,    JR.  35 

into  England,  but  had  there  been  comparatively 
limited  in  its  extension.  In  Paris,  it  extended 
at  once  to  very  large  numbers,  and  assumed 
within  one  week  the  most  terrific  aspect ;  such 
as  to  excite  within  that  short  period  the  most 
outrageous  mobs,  under  a  belief  that  the  poorer 
classes  had  been  designedly  poisoned.  On  the 
sudden  outbreak  of  this  most  alarming  disease, 
my  son's  mind  was  exercised  in  a  distressing 
manner.  The  following  extract  from  his  letter 
of  April  8th,  which  will  be  given  in  full  among 
his  letters,  will  describe  his  feelings,  and  give 
the  result  to  which  he  was  brought  in  this 
dilemma. 

"  I  almost  weep  to  UTite  you  again  from  Paris. 
It  is  now  the  first  moment  of  my  life,  that  I  have 
been  placed  between  two  duties,  each  strong, 
each  binding,  and  where  my  difficulty  is  to 
decide  which  is  the  most  so.  But  I  have  de- 
cided, —  as  I  know,  against  your  wishes.  God 
grant  that  circumstances  may  be  such  that  you 
shall  soon  accord  with  me,  when  the  time  is 
passed.  A  medical  man  has  his  duties ;  —  I  am 
a  boy  in  medicine ;  —  granted.  But  I  am  like 
the  other  Americans  here  about  me.  An  oppor- 
tunity is  offered  us  of  studying  a  disease,  which 
will  probably  visit  our  hitherto  untouched  coun- 


36 


MEMOIR    OF 


try.  Were  the  disease  about  you,  would  you 
fly  ?  You  could  not,  for  the  public  would  look 
to  you.  You  would  not,  for  your  sense  of  duty 
would  prevent  you.  I  am,  in  a  measure,  in  the 
same  condition." 

The  moment  was  a  fearful  one,  most  assuredly. 
The  mortality  in  Paris  rose  to  eight  hundred  a 
day  within  three  weeks  from  the  first  appearance 
of  the  disease.  It  was  in  the  Hotel  Dieu  my 
son  first  saw  the  victims  of  it  in  any  number, 
and  the  emphatic  w^ords  in  which  he  described 
it  were  nearly  the  same,  as  were  often  used  by 
others.  "  The  disease  is  death,"  he  said;  "  truly, 
at  Hotel  Dieu,  where  I  have  seen  fifty  and  more 
in  a  ward,  it  is  almost  like  walking  through  an 
autopsy  room ;  in  many,  nothing  but  the  act  of 
respiration  shows  that  life  still  exists.  It  is 
truly  awful." 

At  a  meeting  of  the  Academy  of  Medicine, 
on  the  evening  of  3d  of  April,  cholera  was  the 
subject  of  discussion,  and  various  suggestions 
and  opinions  were  offered  by  men  of  sanguine 
characters.  My  son  followed  M.  Andral  on  his 
leaving  this  meeting,  and  asked  permission  to 
visit  the  hospital  (la  Pitie,)  at  that  hour,  with 
the  view  of  seeing  any  new  cases  which  might 
have   been  admitted.     M.   Andral  kindly  took 


JAMES    JACKSON,    JR.  37 

him  into  his  cabriolet  and  gave  him  every  facility. 
"  Our  conversation,"  says  my  son,  "  turned  natu- 
rally upon  the  cholera,  and  turning  to  me  with 
a  certain  nod  of  his  head,  which  is  peculiar  to 
him,  and  to  me  very  significant,  for  I  know  that 
it  is  a  thinking  head  which  nods,  — '  I  am  deeply 
interested,'  said  he,  '  my  mind  is  totally  occupied 
by  this  subject ;  but  as  yet  I  see  nothing  which 
is  not  vague ;  —  but  I  shall  go  to  work  upon  it, 
and  I  indulge  the  hope  of  arriving  at  some  val- 
uable results.'  This  is  not  his  exact  language, 
but  it  is  the  idea  ;  —  and  that  idea  inspired  me  ; 
it  seemed  as  if  he  had  imparted  to  me  a  new 
feeling ;  I  may  call  it  a  new  besoin,  so  essential 
have  I  since  found  and  still  find  it  to  satisfy  and 
to  yield  to  it." 

James's  resolution  was  fixed,  and  he  felt  only 
an  ardor  to  study  this  plague  under  his  excellent 
masters  at  la  Pitie,  hoping  he  might  make  his 
knowledge  useful  in  his  own  country,  if  that 
also  should  be  invaded  by  the  universal  epidemic. 
Accordingly  he  devoted  his  whole  heart  and 
mind  to  this  study  during  the  month  of  April, 
only  taking  the  precaution  to  lodge  in  a  healthy 
part  of  the  city,  to  be  cautious  in  his  diet,  and 
to  take  regular  exercise  in  the  open  air.  He 
pursued  the  plan  of  his  master  Louis  in  taking 


38  MEMOIR    OF 

down  with  minuteness  and  fidelity  the  cases, 
which  came  under  his  observation,  and  the 
resuhs  ascertained  by  dissection  in  the  fatal 
cases.  This  labor  occupied  his  whole  time  ;  he 
almost  lived  in  the  hospital.  At  the  end  of  a 
month  he  took  his  papers  to  London  and  there 
arranged  them.  He  made  a  copy  of  sixty  of 
the  most  perfect  of  them,  of  which  thirty  were 
favorable  and  thirty  fatal  in  their  termination. 
From  these  he  made  the  deductions  which  they 
afforded ;  and  this  required  an  exact  analysis  of 
each  case.  To  this  analysis  he  added  the  few 
reflections,  which  he  thought  to  be  fully  author- 
ized by  the  facts,  but  restrained  himself  from 
engaging  in  any  speculations  on  the  subject. 
This  was  a  restraint,  to  which  at  his  age  he 
would  not  have  submitted,  had  he  not  been  fully 
imbued  with  the  rigid,  philosophical  principles 
of  his  master  Louis.  At  the  end  of  May  and 
first  of  June  he  sent  to  me  the  papers  thus  pre- 
pared, in  two  parcels.  Coming  by  prii^ate  hands 
I  did  not  get  them  all  till  the  first  of  August. 
After  obtaining  the  advice  of  a  judicious  friend 
I  determined  to  publish  them,  for  my  son  had 
left  it  to  me  to  do  so  or  not.  I  am  willing  now 
to  refer  to  them  in  support  of  the  praise,  which 
I  have  ventured  to  give  to  my  own  son.     The 


JAMES    JACKSON,    JR.  39 

only  object  of  the  bock  was  to  throw  light  on 
the  pathology,  or  strictly  to  give  the  natural  his- 
tory of  the  disease  and  to  draw  such  inferences 
as  the  facts  afforded.  On  the  treatment  he 
would  not  venture  to  offer  anything,  except  in- 
deed that  the  disease  had  not  thus  far  been 
influenced  by  remedies.  The  book  w^as  pub- 
lished here,  when  the  public  had  begun  to  be 
tired  of  reading  the  numerous  pamphlets  upon  it, 
with  which  the  press  teemed  for  three  months. 
On  this  account  it  did  not  attract  so  much  atten- 
tion as  it  v/ould  have  done  otherwise.  Besides, 
it  promised  no  aid  as  to  the  treatment,  in  which 
the  public  were  naturally  and  properly  most 
interested.  But,  for  its  purpose,  I  might  beg 
that  it  should  now  be  compared  with  any  other 
work  on  the  same  subject,  which  has  been  pub- 
lished anywhere.  This  is  strong  language  and 
I  should  not  be  thus  bold  perhaps,  if  I  claimed 
for  my  son  all  the  merit  of  the  work.  I  did  and 
do  give  to  him  great  credit,  but  the  materials 
were  gathered  under  the  guidance  of,  and  in 
part  directly  from  his  masters  at  la  Pitie,  to 
whom  I  have  so  often  referred. 

While  he  was  engaged  on  this  work  in  Lon- 
don he  made  some  acquaintances  there,  and 
acquaintances   of  the   most  valuable  character. 


40  MEMOIR    OF 

Though  he  went  from  this  country  without 
letters  to  medical  men  in  Paris,  the  friendship  of 
distinguished  physicians  there  had  furnished  him 
with  a  flattering  introduction  to  medical  men  in 
London  and  Edinburgh.  In  London  also  he 
was  received,  almost  at  once,  by  my  friend  Dr 
Boott,  on  whose  character,  and  kindness  to  my 
son  I  shall  refrain  from  making  the  remarks, 
which  my  heart  dictates.  Thus  was  my  son 
enabled  to  gain  access  to  whatever  was  valuable 
in  that  city  both  then  and  in  his  subsequent  visit 
in  the  autumn. 

But  it  was  not  only  by  an  intercourse  with 
professional  men  that  he  was  benefited.  Far 
greater  was  the  advantage,  which  was  afforded 
to  his  mind  and  his  heart,  from  an  introduction 
to  a  select  circle  by  the  gentleman  whom  I  have 
just  named.  In  France  he  had  studied  the 
external  world  only,  under  the  best  of  masters 
indeed,  and  men  whose  whole  conduct  evinced 
the  excellence  of  their  hearts  as  well  as  the 
depth  of  their  science,  and  their  holy  devotion  to 
truth.  But  in  London  he  was  refreshed  by 
being  brought  into  domestic  society  and  among 
people  of  the  greatest  refinement,  whose  minds 
were  engaged  in  the  study  and  the  elevation  of 
the  human  character ;  —  persons  who  were  filled 


JAMES    JACKSON,    JR.  41 

with  philanthropy,  and  who  took  delight  in  fos- 
tering all  the  best  propensities  of  his  heart. "^ 
The  hospitality  of  England  delighted  him ;  and 
for  a  tune  he  became  elevated  almost  beyond 
himself  in  the  little  paradise,  in  which  he  was 
placed.  All  his  good  and  holy  resolutions  were 
strengthened,  and  he  learned  to  view  his  profes- 
sion only  as  the  means  of  being  useful  to  his 
fellow  men. 

The  plan  how^ever,  which  he  had  laid  out  for 
himself,  was  to  spend  a  few  weeks  during  the 
summer  in  Edinburgh,  to  make  a  brief  ^dsit  to 
Ireland,  and  to  get  back  to  London  early  in  the 
autumn.  Accordingly  he  tore  himself  from  the 
dehghtful  circle,  in  w^hich  it  had  been  his  priv- 
ilege to  be  admitted  as  a  friend,  and  made  a 
circuitous  journey  to  Edinburgh,  visiting  many 
interesting  places  on  his  way.  I  am  tempted  to 
give  here  some  extracts  from  his  letters  at  this 
period,  to  show,  not  only  his  readiness  to  avail 
himself  of  opportunities  for  information,  but  also 
the  excellent  spirit  of  those  whom  it  was  his 
happiness  to  meet.  But  enough  will  be  found 
on  this  score  in  the  letters  which  follow,  under 
dates  of  June,  July  and  August,  1832.  The 
letter  of  June  30th  especially,  contains  evidence 

*  See  Note  B. 


42  MEMOIR    OF 

of  the  substantial  hospitality,  not  that  of  the 
table  merely,  which  is  shown  by  men  of  science 
in  Great  Britain. 

In  Edinburgh,  as  elsewhere,  he  was  admitted 
to  free  intercourse  by  the  most  distinguished 
men,  and  had  opened  to  him  every  source  of 
information,  of  which  he  could  avail  himself  in 
so  short  a  visit.  At  Glasgow  he  stopped  only 
to  examine  the  famous  museum  of  Dr  William 
Hunter.  He  walked  over  the  highlands  with  a 
friend  and  fellow-student  from  our  own.  city; 
and  read,  with  vastly  increased  delight,  the  Lady 
of  the  Lake  on  the  borders  of  the  lake  itself. 

The  cholera  was  in  Edinburgh  while  he  was 
there,  and  the  treatment  by  saline  injections  was 
at  that  moment  under  trial.  He  had  spent  half 
a  day  at  London  in  conversation  with  Dr  Stevens 
on  his  peculiar  opinions,  physiological  and  patho- 
logical, those  especially  which  had  a  bearing  on 
the  saline  remedies ;  and  he  was  much  indebted 
to  that  gentleman  for  his  polite  attentions.  On 
his  journey  through  England  he  had  an  oppor- 
tunity of  learning  something  of  the  trial  of  these 
remedies.  Although  not  sanguine  in  his  expec- 
tations, he  attended  to  the  effects  of  the  saline 
injections  in  Edinburgh  with  the  most  ardent 
desire  that  they  might  be  found  useful.     But 


JAMES    JACKSON,    JR.  43 

the  result  in  his  mind  was  the  same,  as  I  believe 
it  has  been  in  the  minds  of  most  of  those,  who 
made  trial  of  this  treatment  of  cholera  in  Europe 
and  America.  His  letter  of  August  10th  goes 
into  some  details  on  this  subject,  and  in  that  and 
others  there  were  many  statements  very  inter- 
esting at  the  moment,  but  which  I  do  not  think 
worthy  of  publication  at  this  time. 

In  his  visit  to  Dublin  he  was  confirmed  in  the 
high  opinion  which  he  had  formed  of  the  excel- 
lent spirit  and  high  scientific  attainments  of  its 
physicians.  There  has  arisen  in  that  city  within 
the  present  century  a  number  of  talented  and 
learned  men,  who  have  labored  much  to  advance 
the  science  of  medicine.  Their  labors  have  not 
been  in  vain,  and  their  merit  is  acknowledged 
in  all  parts  of  the  world ;  at  least  in  all  where 
the  English  language  is  spoken.  My  son  de- 
rived great  advantage  from  the  museum  of  the 
College  of  Surgeons  at  Dublin,  the  value  of 
which  he  thought  greatly  increased  by  a  proper 
catalogue.  He  also  praised  very  highly  the 
excellent  lying-in  hospital  of  that  city. 

Returning  to  London  at  the  end  of  August, 
he  first  indulged  in  the  luxury  of  visiting  the 
friends,  from  whose  society  he  had  already  de- 
rived so  much  pleasure  and  so  much  benefit;  in 


44  MEMOIR    OF 

which  he  found  his  feelings  and  affections  con- 
stantly purified  and  elevated.  He  then  looked 
around  for  the  means  of  pursuing  his  professional 
studies.  He  was  in  truth  too  far  advanced  to 
find  any  adequate  advantage  in  devoting  his 
hours  to  regular  courses  of  elementary  lectures, 
even  though  from  most  distinguished  men.  Sur- 
gery he  did  not  meddle  with  ;  and  the  mode  of 
pursuing  pathological  researches  in  the  London 
hospitals  did  not  seem  to  him  at  all  equal  to 
those,  which  he  had  witnessed  at  la  Pitie.  It 
happened  that  the  arrangements  for  the  Avinter 
would  not  permit  him  to  hear  the  clinical  lectures 
of  those  physicians,  whom  he  would  have  been 
most  pleased  to  attend.  He  found  then  those 
monuments  of  industry  and  science,  the  anatom- 
ical museums  of  London,  to  be  the  only  objects, 
which  in  the  actual  state  of  his  mind  and  at  his 
stage  of  study,  could  repay  him  for  delaying  his 
return  to  Paris.      He  had  before   desisrned  to 

o 

revisit  this  city  in  the  spring  for  a  few  weeks, 
after  passing  the  winter  in  London.  But  he 
now  decided  that  his  winter  could  be  spent  most 
profitably  in  Paris.  At  once  then  he  engaged 
in  the  study  of  the  excellent  museum  of  morbid 
anatomy  at  Guy's  hospital,  which  owes  its  ex- 
istence  to    Dr  Hodgkin.     This  most  pure  and 


JAMES   JACKSON,    JK.  45 

philanthropic  physician  afforded  him  every  pos- 
sible assistance.  My  son  examined  each  pre- 
paration carefully,  inquiring  minutely  into  the 
history  of  the  subject  from  whom  it  was  derived, 
and  taking  notes  as  he  proceeded,  especially  in 
cases  where  the  whole  history  could  be  obtained. 
This  study  occupied  him  a  fortnight. 

He  next  visited  the  museum  of  John  Hunter, 
now  belonging  to  the  Royal  College  of  Surgeons 
of  London.  Having  learned  in  the  first  year  of 
his  medical  studies  to  venerate  the  name  of  the 
great  author  of  this  stupendous  work,  he  went 
to  it  with  the  highest  anticipations.  His  delight 
in  seeing  it  was  even  greater  than  he  had 
expected,  and  he  thought  that  he  derived  great 
advantage  as  well  as  pleasure  from  his  visits  to 
it.  But  he  saw  that  the  advantage  might  have 
been  much  greater  under  more  favorable  circum- 
stances. His  remarks  on  this  subject,  or  some 
of  them,  are  given  in  his  letters  of  September, 
1832.  The  want  of  a  catalogue,  a  want  which 
is  about  to  be  supplied,  made  it  impossible  for 
him  to  study  the  preparations  in  a  useful  manner, 
notwithstanding  the  excellence  of  their  scientific 
arrangement. 

I  ought  not  perhaps  to  omit  an  acknowledg- 
ment of,  what  he  felt  very  strongly,  the  pleasure 


46  MEMOIR    OF 

and  profit  he  derived  from  an  intercourse,  in 
which  he  was  indulged,  with  some  eminent 
medical  men  in  London ;  and  I  cannot  omit  to 
say  that  Sir  Astley  Cooper,  one  of  the  teachers 
on  whom  I  myself  attended  more  than  thirty 
years  before,  was  among  them.  But  my  son 
was  so  short  a  time  in  London  that  he  could  not 
acquire  a  very  accurate  knowledge  of  individuals 
there  ;  and  I  do  not  deem  it  proper  to  quote  his 
transient  remarks  on  them,  although  these  re- 
marks were,  for  the  most  part,  both  respectful 
and  accompanied  by  strong  expressions  of  grati- 
tude. 

On  his  return  to  Paris,  about  the  20th  of 
October,  my  son  engaged  at  once  under  the 
greatest  advantages  in  his  attendance  at  the 
Hospital  la  Pitie.  He  was  now  well  prepared 
for  observation  of  the  phenomena  of  disease  in 
the  living  and  the  dead.  In  addition  to  what 
he  had  previously  gained,  he  now  had  the  ad- 
vantage of  having  learned  many  of  the  views 
and  opinions  of  the  greatest  living  masters  on 
the  leading  questions  in  pathology.  He  knew 
that  his  whole  life,  of  such  a  length  as  he  then 
had  reason  to  anticipate,  would  be  too  short  for 
the  full  solution  of  these  questions,  even  to  his 
own  satisfaction.     He  knew  also  the  inestimable 


JAMES    JACKSON,  JR.  47 

value  of  the  opportunities  aftbrded  him  in  Paris 
for  this  purpose,  such  as  he  could  not  look  for 
again ;  a  value  increased  tenfold  by  the  aid  and 
guidance  of  his  beloved  and  revered  master.  It 
was  at  this  time  that  M.  Louis  almost  adopted 
him  as  a  son,  admitting  him  to  the  most  unre- 
served intercourse,  and  affording  him  every  pos- 
sible facility  in  the  wards  under  his  care.  There 
James  devoted  himself  entirely  to  careful  obser- 
vation and  the  collection  of  facts.  Not  to  a 
selection  of  the  facts,  which  favored  particular 
doctrines ;  but  really  and  truly  to  an  exact 
inquisition  into  all  the  facts  appertaining  to  the 
cases  before  him.  These,  as  far  as  time  would 
permit,  were  all  carefully  noted  on  the  spot  in 
his  daily  visits ;  and  these  visits  were  not  limited 
to  the  regular  hours  of  the  physician.  By  the 
orders  of  M.  Louis  he  was  admitted  at  all  hours, 
and  permitted  to  pass  most  of  his  day  in  the 
collection  of  his  cases.  Fully  aware  how  much 
is  lost  to  us  in  hospitals,  in  comparison  with 
private  practice,  from  not  being  acquainted  -w^th 
the  families  and  with  the  personal  constitutions 
and  morbid  dispositions  of  the  patients,  he  en- 
deavored to  get  a  compensation  by  the  most 
exact  inquiries  on  these  points.  From  the  pa- 
tient, or  his  friends  who  visited  him,  he  constantly 


48  MEMOIR    OF 

sought  an  answer  to  the  following  and  similar 
questions,  viz.  Where  was  the  patient  born 
and  Avhen  ?  Was  he  nursed  at  the  breast  of  his 
mother,  or  of  a  stranger  ?  What  have  been  his 
occupation  and  his  habits  of  life  ?  What  have 
been  his  previous  diseases  ?  Do  his  parents 
live  ;  if  not,  at  what  age  did  they  die  ;  to  what 
diseases  were  they  and  their  relatives  subject ; 
and  of  what  diseases  did  they  die  ?  Were  they 
affected  by  palsy,  asthma,  or  any  disease  of  the 
thorax?  If  so,  w^hat  particular  symptoms  did 
they  manifest  ?  Has  the  patient  any  children  ? 
If  so,  do  they  live  and  with  what  diseases  have 
they  been  affected  ? 

The  observations  thus  collected  were  all  of 
them  such  as  he  could  himself  have  employed 
usefully,  in  connexion  with  others  of  a  similar 
kind,  in  seeking  answers  to  many  general  ques- 
tions. For  instance,  he  noticed,  and,  so  far  as  I 
know,  he  first  noticed  the  frequency  with  which 
asthma  and  either  apoplexy,  or  palsy  occur  in 
the  same  family.  To  ascertain  the  accuracy  of 
this  observation,  he  inquired  of  all  those  he* 
examined,  whether  asthmatic  or  not,  if  these 
diseases  of  the  nervous  system  had  occurred  in 
their  families.  But,  valuable  as  the  cases  he 
collected  would  have  been  to  himself,  the  larger 


JAMES    JACKSON,    JR.  49 

part  of  them  were  not  such  as  could  repay  a 
perusal  by  others.  Those,  in  which  the  event 
was  fatal,  and  where  the  details  were  full  and 
precise,  are  the  most  instructive  to  others.  It  is 
from  among  those  principally  that  the  cases  in 
this  hook  have  been  selected.  These  are  not 
sufficiently  numerous  to  furnish  positive  answers 
to  many  interesting  questions.  They  are  to  be 
regarded  as  contributions  to  medical  science  ; 
and,  when  they  shall  be  taken  in  connexion  with 
many  similar  observations,  the  whole  being  care- 
fully analysed,  they  will  give  results  of  perma- 
nent value.  They  are  printed  with  this  view ; 
and  a  peculiar  encouragement  to  expect  benefit , 
from  them  is  derived  from  circumstances,  which 
I  shall  proceed  to  mention. 

In  the  year  1832  there  was  formed  in  Paris  a 
Society  entitled  "  The  Society  of  Medical  Obser- 
vation." It  had  for  its  first  President  M.  Louis, 
and  for  its  Vice  Presidents  MM.  Chomel  and 
Andral.  Its  active  members  were  young  men. 
who  were  proud  to  call  M.  Louis  their  master. 
Their  object  was  to  accumulate  observations, 
made  with  the  accuracy  which  their  President 
had  inculcated  both  by  precept  and  example,^ 
and  to  draw  from  them  the  inferences,  which  a 

*  See  note  C. 
4 


50  MEMOIR    OF 

careful  comparison  of  them  should  permit.     Of 

• 

this  society,  ori^nally  very  small,  its  members 
being  from  different  countries,  my  son  was  a 
member  at  its  formation.  It  was  one  of  his  first 
desires  to  contribute  his  proportion  of  materials 
to  its  stores ;  stores  which  must  become  ample 
if  its  plan  is  not  abandoned,  and  which  will  be 
opened  freely  to  all  the  world. 

During  his  residence  in  Europe  my  son  had 
a  strong  desire  to  visit  Germany,  fully  aware  of 
the  means  there  to  be  found  for  increasing  med- 
ical knowledge,  as  well  as  of  the  benefit  of  per- 
sonal communication  with  those,  whose  lives 
have  been  devoted  to  science  and  whose  minds 
are  stored  with  it.  Each  has  his  own  mode  of 
viewing  objects  and  of  presenting  them  to  the 
minds  of  others.  From  every  one  something  is 
to  be  gained.  But,  on  the  other  hand,  if  one  is 
limited  by  time,  his  mind  may  suffer  from  the 
kind  of  dissipation  which  arises  from  visiting 
even  rich  mines  of  learning,  into  which  he  does 
not  enter  as  a  laborer.  From  considerations  of 
this  kind,  very  judiciously  urged  by  M.  Louis, 
my  son  resisted  the  temptation  and  gave  himself 
up  to  observation  of  disease  at  la  Pitie,  as  has 
been  stated.  He  had  fixed  on  the  end  of  June, 
1833,  as  the  period   when  he   should  relinquish 


JAMES    JACKSON,    JR.  51 

this  employment,  which  grew  more  interesting 
every  day.  When  July  arrived  he  scarcely 
knew  how  to  tear  himself  away,  though  he  felt 
at  the  same  time  an  eager  desire  to  revisit  his 
own  family.  Especially  the  idea  of  leaving 
M.  Louis  forever  was  afflicting  to  him  in  the 
highest  degree.  Never  was  attachment  more 
just  on  the  part  of  a  pupil  to  a  master,  and  never 
could  it  have  been  warmer,  or  more  sincere. 
M.  Louis  gave  him  some  beautiful  articles  as 
testimonials  of  his  affection,  and  the  delight, 
with  which  he  subsequently  regarded  them,  fre- 
quently made  his  eyes  swim  with  tears.  I  can- 
not resist  the  gratification  of  inserting  the  note 
by  which  these  articles  were  accompanied,  as 
also  my  son's  last  letter  to  me  from  Paris. 


Translation  of  a  note  from  M.  Louis  to  J.  Jackson,  Jr.  on 
his  leaving  Paris,  accompanied  with  a  bronzed  inkstand 
and  two  pieces  of  marble,  of  which  one  was  surmounted 
by  the  famous  dog  of  St  Bernard,  bearing  a  child  on  its 
back  ;  to  which  reference  is  made  in  the  note. 

There  is  a  satisfaction,  though  I  confess  it  is 
accompanied  by  feelings  which  render  it  a  very 
slight   one,  in  leaving  some   token  of  remem- 


52  MEMOIR    OF 

brance  with  friends  from  whom  we  are  about  to 
part;  yet  a  satisfaction  it  certainly  is,  and  for 
that  reason,  my  dear  friend,  I  beg  you  to  permit 
me  to  enjoy  it.     Your  thoughts  would  very  nat- 
urally dwell  at  times  upon  your  good  friends  in 
Paris ;  but,  for  my  part,  I  choose   you   should 
have  something  to  recall  them  more  particularly 
to  your  recollection.     I  must  therefore  beg  you 
to  accept   this  inkstand,  which  I  hope  you  will 
keep  upon  your  study  table,  and  these  two  little 
pieces  of  marble,  which  will  serve  to  keep  in 
their  places  the  leaves  upon  which  you  will  be 
writing  the  results  of  your  researches.     From 
these  researches  let  nothing  divert  you ;  be  con- 
stant in  your  pursuit  three  or  four  years  and  do 
not  let  the  poor  child  whom  the  faithful  dog  is 
bearing  to  his  home,  speak  too  feelingly  to  your 
heart.     Do  not  forget  that  you  are  to  be  one  of 
the  lawgivers  in  our  art ;  and  that,  if  it  is  our 
duty  upon  earth  to  use  our  faculties  in  the  best 
possible  manner  and  for  the  advantage  of  the 
greatest  number,  you  owe  yourself  to  observation. 
Your  future  fortune  will  be  none  the  less,  and 
the  satisfaction  you  will  derive  from  four  years' 
labor  will  be  incomparably  greater.     Be  assured 
that  my  best  wishes  follow  you  wherever  you 
go,  that  no  one  can  more  sincerely  desire  your 


JAMES    JACKSON,    JR.  53 

happiness,  that  I  fully  appreciate  the  value  of 
your  friendship  and  of  your  esteem,  and  that  I 
should  be  most  happy  to  be  able  to  give  you 
proofs  of  it.     Farewell,  my  dear  friend. 

(Signed,)  Louis. 

July  10, 1833. 


Parts,  July  13,  1833. 
MY    DEAR    FATHER, 

In  two  hours  I  am  out  of  Paris.  I  will  not 
attempt  to  describe  to  you  the  agony  it  gives  me 
to  quit  Louis.  He  is  my  second  father,  and 
God  knows  that  is  a  name  I  of  all  men  cannot 
use  lightly.  I  may  not  persuade  you  to  look 
upon  him  with  my  eyes  exactly  as  a  scientific 
man ;  but  in  your  heart  he  must  have  the  share 
of  a  brother ;  for  he  almost  shares  my  affection 
with  you.  From  one,  upon  whom  I  had  no 
claims,  but  those  which  my  life  and  mind  and 
habits  gave  me,  I  have  experienced  a  care,  an 
affection  which  I  never  could  dare  expect  from 
any  but  my  dear  father,  and  which  I  shall  ever 
feel  to  be  the  most  honorable  and  truly  worthy 
prize  of  my  life.  To  meet  with  satisfaction  in 
the  eyes  of  such  a  man,  and  to  hold  a  place  in 
his  heart  as  I  do,  I  allow  I  am  proud  of.     But, 


64  MEMOIR    OF 

my  dear  father,  I  cannot  write  ;  I  am  sittmg 
here,  expecting  to  see  Louis  for  the  last  time  in 
my  life,  and  it  is  only  upon  the  occasion  of  quit- 
ting yourself,  whom  I  have  ever  felt  to  be  a  part 
of  me,  that  I  have  suffered  as  I  do  at  present. 
The  ties  of  relationship  are  strong,  the  strongest 
when  that  relationship  is  close  and  dependent ; 
especially  if  it  be  mingled  with  the  strongest  and 
warmest  sympathies.  But  one's  mind's  friends, 
the  hearts  that  not  nature,  but  our  oa\ti  characters 
have  given  us,  the  friend,  who  not  father  to  our 
bodies,  has  yet  been  and  is  ever  to  be  the 
source,  fountain  and  direction  of  the  dearest 
thoughts  of  our  minds,  that  friend  and  that  rela- 
tionship is  also  dear.  It  is  that  friendship  I  must 
now  quit,  probably  forever ;  it  is  that  relationship 
that  in  the  person  I  must  now  break,  though 
in  the  mind  and  in  the  heart  it  can  never  be  bro- 
ken. Till  now,  I  knew  not  how  I  loved  my 
French  master.  I  know  well  I  shall  rarely  be 
called  to  such  trials  ;  they  can  occur  but  few 
times  in  life.  Thank  God,  that  with  me,  grief 
is  as  short,  as  it  is  poignant,  and  that  in  a  few 
days  nought  will  occupy  my  mind,  but  the  anti- 
cipations of  the  joys  of  home.  Once  more  in 
the  arms  of  my  beloved  family,  and  under  the 
wings  of  my  dear  father,  and  I  can  imagine  no 
higher  joy. 


JAMES    JACKSON,    JE.  55 

In  addition  to  the  testimonials  of  M.  Louis's 
affection  above  referred  to,  my  son  obtained 
shortly  before  he  left  Paris  another  memorial  of 
him,  which  he  valued  as  above  all  price.  This 
was  a  picture,  and  an  excellent  likeness  of  his 
master,  executed  by  Champmartin,  which  M. 
Louis  very  kindly  consented  to  sit  for.  The 
emotions  which  my  son  experienced  on  the  arri- 
'  val  of  this  picture,  which  was  during  his  conva- 
lescence from  his  fever  in  December,  1833,  were 
too  strong  and  too  deep  to  admit  of  description. 
From  his  younger  friends  also,  James  could  not 
part  without  the  greatest  sensibility  ;  from  those 
especially  whose  home  was  in  Europe.  To  one 
of  these,  M.  Maunoir,  of  Geneva,  he  felt  the 
attachment  of  a  brother.  Some,  or  all  of  these 
friends,  perhaps,  were  surprised  not  to  hear  more 
from  him  after  his  return  to  this  country.  I 
therefore  avail  myself  of  this  opportunity  to  say 
to  them  that  he  survived  his  return  to  us  scarcely 
seven  months  ;  that  half  of  that  time  was  passed 
in  the  chamber  of  sickness  ;  that,  in  the  residue, 
he  could  not  find  time  to  respond  fully  to  the  kind 
expressions  of  affection  and  most  friendly  atten- 
tions on  his  return  and  during  his  first  sickness, 
which  were  abundantly  poured  out  upon  him  ; 
while  he  had  also  professional  objects  constantly 


56  MEMOIR    OF 

calling  for  his  observation.  The  friends,  to 
whom  I  allude,  will  well  understand  how  much 
interested  he  was  in  the  inquiry  as  to  certain 
points  in  typhus  fever  in  this  country,  in  regard 
to  tuberculous  cases  and  many  similar  subjects, 
which  had  interested  him  and  them  in  Paris. 

Under  any  circumstances  my  son's  gloomy 
feelings  on  leaving  Paris  would  soon  have  sub- 
sided, although  without  any  forgetfulness  of  what 
he  had  left  behind.  His  natural  cheerfulness 
was  sufficient.  But  he  had  also  the  pleasures 
of  home  in  view,  and  he  had  more  immediately 
the  joy  of  seeing  his  friends  in  London,  and  the 
prospect  of  crossing  the  Atlantic  with  a  rare 
company  of  friends,  as  fellow-passengers.  It 
may  seem  like  romance  to  speak  thus  of  his 
happiness  in  finding  rare  and  excellent  friends 
at  every  turn.  Yet,  if  it  were  well  to  bring  out 
the  evidence,  many  who  will  read  this  would 
know  that  this  language  is  quite  as  cool  as  the 
subject  will  permit. 

I  shall  not  however  dwell  on  the  high  gratifi- 
cation he  received  during  a  few  days  passed  in 
London  and  Liverpool,  nor  that  which  attended 
his  voyage  to  this  country.  The  ship  which 
brought  him  arrived  at  New  York  on  the  23d  of 
August,  1833,  with  a   precious  freight,   which 


JAMES    JACKSON,    JR.  57 

rejoiced  many  hearts  besides  those  of  my  family. 
For  my  household  how  little  then  seemed  there 
occasion  to  apprehend  the  sad  sufferings,  to  which 
they  were  soon  to  be  called.  The  dangers  of 
the  sea  and  the  risks  of  a  long  absence  were 
over,  the  fearful  cholera  had  left  my  son  untouch- 
ed, and  now  we  embraced  him  as  if  we  had  a 
security  of  the  happiness  he  was  so  capable  and 
so  anxious  to  afford  us.  He  could  indulge  his 
heart  at  this  moment  in  expressing  his  love  for 
his  friends  with  an  ardor,  which  the  cold  manners 
of  our  country  scarcely  permit  on  ordinary  occa- 
sions, and  he  was  almost  in  a  delirium  of  joy. 
But  after  an  indulgence  of  this  kind  for  two  or 
three  weeks,  he  felt  that  the  serious  business  of 
life  called  him,  and  sought  to  renew  his  obser- 
vations on  disease. 

The  opportunities  offered  him  for  this  purpose 
were  ample,  though  not  so  great  as-  those  he  had 
left  in  Paris.  My  connexion  with  the  Massa- 
chusetts General  Hospital  afforded  him  every 
facility  at  that  institution.  Besides,  here  as  eve- 
rywhere, he  met  the  kindest  attentions,  and  he 
soon  found  that  the  most  busy  among  the  medical 
men  of  our  city  were  ready  to  show  him  their 
important  cases  and  to  invite  him  to  their  post- 
mortem examinations.     In  this   way  his   time 


58  MEMOIR    OF 

was  abundantly  occupied  ;  and  in  accepting  the 
kind  hospitalities  of  numerous  friends  it  was 
more  than  occupied.  He  was  constantly  under 
too  great  a  pressure  and  I  was  seeking  how  to 
prevent  it.  The  temptations  came  day  by  day, 
and  in  so  many  instances  were  the  results  of 
the  most  friendly  kindness,  that  to  resist  at  once 
was  impossible.  Our  autumnal  fever  was  prev- 
alent much  more  than  usual,  and  with  some 
uncommon  severity.  The  opportunity  to  study 
this  and  to  compare  it  with  the  fever  of  Paris, 
on  which  Louis  had  written  so  admirably,  was 
one  which  he  could  not  forego.  And  when  he 
found  that  this  disease  exhibited  in  the  livino: 
and  in  the  dead  the  same  characters,  which  his 
master  had  so  accurately  delineated,  his  ardor 
was  increased  more  and  more,  and  he  put  all  his 
powers  to  their  greatest  trial.  It  is  not  surpris- 
ing, in  the  retrospect,  that  he  became  affected 
with  the  prevailing  disease.  He  was  attacked 
just  two  months  after  his  arrival  in  New  York, 
and  underwent  this  fever  in  a  very  severe  form. 
Some  of  my  sanguine  brethren  will  ask  why  we 
did  not  crush  the  disease  at  once  ?  It  is  in 
accordance  with  my  experience  certainly,  that,  in 
most  instances,  the  early  use  of  active  remedies, 
of  which  antimonials  are   the  most  important, 


JAMES    JACKSON,    JR.  59 

will  diminish  the  violence  of  this  fever,  and  in 
many  cases  will  arrest  it.  But  in  some  instances 
a  peculiarly  irritable  state  of  the  alimentary 
canal  will  not  permit  the  use  of  these  remedies ; 
or,  evil  only  will  follow  their  use.  Such  was 
my  son's  case  ;  owing  in  part  to  a  stomach  natu- 
rally irritable,  but  in  part  also  to  an  intestinal 
disease  which  he  had  suffered  abroad.  Notwith- 
standing some  active  treatment  at  the  beginning 
the  fever  took  its  course,  and  during  the  second 
and  third  week  its  result  was  very  uncertain. 
It  then  became  more  mild,  yet  for  six  weeks  he 
was  unable  to  assume  the  erect  position.  His 
convalescence  was  not  rapid,  but  in  three  months 
from  its  commencement  he  seemed  to  be  in  per- 
fect health,  having  then  been  three  weeks  riding 
and  walking  abroad.  His  convalescence  was 
not  destitute  of  pleasure  to  him ;  on  the  contrary 
he  spoke  of  it  as  a  happy  period  ;  he  thought  it 
good  for  him  to  have  been  sick,  that  he  should 
better  know  how  to  minister  to  others,  and  that 
his  own  heart  would  be  the  better.  His  sensi- 
bility to  the  kindness  of  his  friends  and  the 
pleasure  he  derived  from  them  were  also  increas- 
ed ;  and  we  all  meanwhile  promised  ourselves 
that  his  health  would  become  more  firm. 

The  time  now  arrived  when  he  should  apply 


60  MEMOIR    OF 

for  admission  as  a  Doctor  of  Medicine  in  our 
University.  If  he  had  been  at  home  he  might 
have  taken  this  step  in  August,  1S31.  He  had 
now  been  five  years  and  a  half  engaged  in  the 
study  of  medicine.  It  could  not  be  a  question 
whether  he  could  pass  the  requisite  examination. 
Yet  he  felt  some  anxiety,  because  he  thought  it 
would  be  shameful  for  him  to  be  found  deficient 
in  any  point.  This  examination  was  about  the 
middle  of  February.  He  had  seemed  quite  well 
at  the  end  of  January  and  beginning  of  Febru- 
ary. But  he  now  appeared  less  firm,  and  had 
some  recurrence  of  a  diarrhoea,  which  had 
afflicted  him  in  France.  I  attributed  this  to  the 
momentary  anxiety  he  felt  as  to  the  examination, 
and  to  the  deeper  anxiety  as  to  the  more  weighty 
duties  which  were  before  him  ;  as  he  was  soon 
to  enter  on  the  reponsible  duties  of  his  profession. 
The  examination  being  passed,  and  the  degree 
conferred,  I  felt  desirous  that  he  should  make  his 
arrangements  at  once  to  engage  in  business, 
hoping  that  he  would  feel  a  tranquillity  when 
this  was  done.  But  I  was  in  an  error  as  to 
the  cause  of  his  difficulty.  It  was  a  physical 
and  not  a  moral  one.  He  thought  his  diarrhoea 
was  no  more  than  he  had  often  had  before.  But 
suddenly  the  disease  grew  worse,  it  assumed  the 


JAMES    JACKSON,    JR.  61 


character  of  severe  dysentery  and  he  was  entirely 
prostrated  at  once.  Under  this  disease  he  suf- 
fered much  and  struggled  hard,  retaining  his 
firmness  of  mind  and  fully  aware  of  the  uncer- 
tainty of  its  issue.  He  was  severely  sick  about 
three  weeks,  but  after  the  first  fortnight,  I  re- 
garded him  as  safe.  The  dysenteric  affection 
was  clearly  subsiding,  and  he  recovered  some 
appetite,  though  still  very  weak.  Suddenly  a 
change  occurred,  of  which  the  cause  was  latent ; 
the  prostration  was  extreme ;  his  mind  gave 
way,  and  in  less  than  two  da^^s  and  a  half  he 
ceased  to  breathe.^  In  his  last  hours,  his  mind, 
amidst  many  wandering  thoughts,  appeared  to 
get  momentary  glimpses  of  his  real  situation. 
He  did  not  seem  to  shrink  from  the  view,  but 
was  unable  to  keep  it  before  him  from  failure  in 
his  physical  strength.  In  one  of  these  moments 
he  said  very  distinctly  and  solemnly,  "  God,  par- 
don me."  That  he  had  sins  which  called  for 
this  petition  at  all  times  there  is  no  doubt.  That 
he  was  deeply  sensible  of  his  own  frailties  and 
imperfections  I  well  knew,  for  no  son  was  ever 
more  frank  than  he  was  in  communications  to  a 
father.  That  the  prayer  from  a  heart  like  his, 
not  now  uttered  for  the  first  time,  was  freely 

*  See  note  D. 


62  MEMOIR    OF 

granted,  it  was  impossible  for  me  to  doubt.  His 
own  humble  penitence  was  highly  proper.  But 
for  me,  there  was  no  fear  that  he  would  find  any- 
thing but  bliss  in  the  new  state  of  existence  into 
which  my  mind  seemed  almost  capable  of  fol- 
lowing him ;  almost,  of  seeing  his  admission. 
It  was  for  my  own  loss,  for  that  of  my  house- 
hold, I  had  to  grieve.  And  that  grief,  sincere  as 
it  was,  found  solace  from  the  first  in  the  delight- 
ful recollection  his  life  had  left  on  my  mind. 
These  recollections  have  constantly  hung  about 
it,  and  how  grateful  they  have  been  may  be  seen 
by  what  I  have  transcribed  in  the  preceding 
pages. 

As  I  have  not  very  strictly  followed  the  plan 
which  I  laid  down,  there  remain  to  be  traced 
more  distinctly  some  of  the  features  of  my  son's 
character.  His  cheerfulness  and  gaiety  of  heart 
have  been  before  mentioned.  The  influence  of 
these  on  the  society  around  him  was  often  recog- 
nised by  his  friends.  It  was  heightened  among 
those,  who  had  become  acquainted  with  his  purity 
and  the  sincerity  of  his  interest  in  others.  He 
was  described  very  appropriately  by  one,  who 
knew  him  well  and  loved  him  much,  as  having 
a "  morning   freshness,"   which   shed   gladness 


JAMES    JACKSON,    JR.  63 

where  he  went."^     He  never  took  the  lead  among 
his  friends,  and  his  influence  was  not  manifest ; 
of  course  it  was   not   offensive,  nor   annoying. 
It  was  nevertheless  great  and  extensive,  so   that 
each  one  was  surprised  at  last  to  find  that  there 
were  so  many  besides  himself  whose   happiness 
was  promoted  by  him.     The  number  of  friends, 
by  whom  he  was  admitted  to  intimacy,  was  large. 
The  reason  was  that  he  loved  men  for  different 
good  qualities,  and  showed  his  interest  in  those 
he  loved.     He  did  not  shut  his  eyes   to    their 
faults  ;  he  examined  them   critically,  but  not  for 
purpose  of  reproach ;  he   regarded  those  faults 
as  misfortunes,  which  he  should  assist  his  friends 
to  overcome.     I  suspect  thas  he  often  performed 
the  hardest   duty   of  friendship  ;  he   told  their 
faults  to  many.     If  he  had  not   done    it   gently 
and  in  love  they   would   have   been   offended. 
They  were   not   oflfended.     His   most   intimate 
friend  has  told  me  that  he  exercised  a    salutary 
influence  in  certain   cases,   where   friends   of  a 
sterner  character  were  not  listened  to. 

In  the  society  of  the  young  he  would  give 
himself  up  to  sport,  so  that  it  might  have  been 
doubted  whether  he  could  think  soberly  ;  and 
from  the  warmth  of  his  feelings  it   might   have 

*  See  note  E. 


64  MEMOIR    OF 

been  argued  that  he  could  not  exercise  his 
judgment  coolly.  Yet  he  was  exact  and  dis- 
criminating in  the  investigation  of  facts,  which 
related  to  science,  and  rigid  in  his  deductions 
from  them.  This  union  of  coolness  of  the  head 
with  warmth  of  the  heart  is  rare,  and  this  partly 
explains  the  circumstance  of  his  finding  favor 
with  persons  of  very  different  character. 

There  was  something  agreeable  in  his  man- 
ners certainly,  which  recommended  him  to  good 
men  ;  for  he  quickly  gained  the  favor  of  good 
men  Avherever  he  went.  Though  he  had  acquir- 
ed sufficient  polish  of  manner  while  abroad, 
there  was  not  enough  of  it  to  be  a  peculiar 
recommendation.  So  far  as  his  manners  w^ere 
agreeable  then  it  was  not  from  any  polish ;  it 
was  from  their  manifestation  of  the  good  feelings 
already  described. 

I  cannot  omit  remarking  here  the  sincere  rev- 
erence for  age,  which  he  imbibed  very  early  in 
life  and  always  maintained ;  which,  far  from 
checking  his  intercourse  with  the  aged,  made 
him  seek  it,  both  that  he  might  minister  to  their 
comfort,  and  that  he  might  gain  by  their  wisdom. 

The  principle  of  gratitude  was  very  strong  in 
him.  He  did  not  easily  forget  the  slightest 
favor,  and  his  heart  was  burning  with   affection 


JAMES    JACKSON,    JR.  65 

toward  those,  who  had  rendered  him  important  ser- 
vices. He  deemed  no  services  so  great  as  those, 
by  which  his  heart  was  made  better  ;  and  hence 
arose  his  strong  feelings  toward  his  English 
friends,  among  whom  he  was  placed  at  a  moment 
when  his  heart  was  truly  hungering  for  the  things 
which  could  elevate  and  purify  it. 

What  shall  I  say  of  his  ambition  ?  The  word 
is  an  equivocal  one.  Or,  perhaps,  the  question 
should  be  of  what  was  he  ambitious.  I  think 
his  young  friends  and  associates  will  agree  that 
he  was  not  anxious  for  honorary  distinctions. 
He  had  not  such  a  spirit  of  emulation  as  leads 
one  to  study  hard,  so  that  he  may  get  the  highest 
rank  among  his  fellows.  He  could  rejoice  most 
sincerely  in  seeing  his  friends  gain  honors,  while 
he  remained  unnoticed.  Envy,  I  think,  scarcely 
sprouted  in  his  breast ;  I,  who  knew  him  well, 
could  never  see  the  slightest  evidences  of  that 
baneful  feeling.  But  he  had  the  strongest  ambi- 
tion to  be  worthy  the  esteem  and  love  of  the  wise 
and  good.  He  rejoiced  openly  when  he  made 
any  acquisition  in  knowledge ;  he  thanked  God 
reverently  when  he  thought  he  had  made  any 
advance  in  virtue.  But  so  far  from  wishing 
that  others  might  be  less  that  he  might  be  great, 
he  would  labor  to  communicate  to  his  fellows,  in 
5 


66  MEMOIR    OF 

a  mode,  not  offensive  to  their  self-love,  every 
acquisition  he  had  made.  He  even  took  pains 
to  manage  this  in  some  cases,  so  as  not  to  seem 
to  be  bestowing  what  he  was  very  anxious  to 
give.  He  made  it  his  aim  to  go  as  far  in  the 
branch  of  his  profession,  to  which  he  particularly 
devoted  himself,  as  any  other  man  ;  and  he  said 
to  me,  after  his  return  from  abroad,  that  he  had 
at  some  periods  indulged  hopes  of  such  honors 
as  our  profession  could  afford  ;  but  that  he  had 
then  totally  renounced  all  such  hopes  and  wishes 
for  that,  which  he  deemed  of  much  more  impor- 
tance, the  being  truly  useful  to  his  fellow-men. 
As  to  wealth,  he  loved  the  good  uses  of  it,  but  he 
indulged  no  anxiety  for  it ;  and  he  was  not  prone 
to  such  extravagance  in  his  expenses,  as  made 
it  necessary  for  him. 

During  his  college  life  he  had  made  some  at- 
tainments in  general  literature ;  not  such  as  to 
give  him  claims  to  any  distinction  on  that  score, 
yet  enough  to  give  him  a  taste  for  more.  He 
hoped  to  have  a  period  in  which  he  could  do 
more  in  this  way.  But,  in  the  few  years  he 
devoted  to  professional  studies,  he  did  not  feel  at 
liberty  to  spare  many  hours  to  other  subjects.  — 
To  politics  he  gave  very  little  attention,  and  this 
only  to  what   he  could   learn   in  conversation. 


JA3IES    JACKSON,    JR.  67 

During  moments  of  political  excitement  in  France 
and  England,  in  1S32  and  1833,  he  could  not 
avoid  taking  some  notice  of  passing  events ; 
and,  like  all  young  men  of  ardent  tempers,  he 
sided  with  those  who  thought  more  of  the  attain- 
ment of  liberty,  than  of  the  security  which  it 
requires  to  render  it  a  real  blessing. 

I  may  seem  to  have  said  enough  of  his  indus- 
try in  the  earlier  pages  of  this  memoir,  yet  I 
must  state  some  of  the  evidences  that  in  Europe, 
when  left  to  himself,  it  was  even  greater  than 
when  under  my  roof.  While  he  was  abroad, 
with  three  necessary  exceptions,  he  wrote  to  me 
by  every  regular  packet  to  New  York,  from  Ha- 
vre or  from  Liverpool.  The  letters  were  not 
ordinarily  short ;  some  of  the  extracts  which 
follow  will  prove  that  they  w^ere  not  always  so. 
They  were  frequently  four  full  sheets.  These 
letters,  with  some  to  other  persons,  w^ere  so  volum- 
inous, that  I  have  thought  it  right  to  enumerate 
them  among  the  proofs  of  his  industry.  But 
they  amount  to  nothing  in  comparison  with  the 
papers  of  other  kinds,  which  occupied  his  pen 
while  abroad.  These  were,  1st.  His  cases,  taken 
at  the  bedside  in  brief  notes,  many  of  them  in 
French,  and  which  amount  I  believe  to  fifteen 
hundred  pages  at  least,  and  some  of  these  were 


68  MEMOIR    OF 

copied  and  stated  in  full  in  the  French  language  ; 
2d.  Many  notes  from  books  and  from  conversa- 
tion with  distinguished  persons,  accompanied 
often  by  his  own  reflections,  making  not  less 
than  eight  hundred  pages  in  his  common-place 
book  ;  and  3d.  The  translation  of  a  large  portion 
of  Andral's  Clinique  Medicale. 

During  the  same  period  he  made  himself 
familiar  with  the  French  medical  literature  of 
the  present  day,  studying  a  large  number  of  vol- 
umes with  great  care.  It  would  thus  seem  that 
no  small  portion  of  his  time  must  have  been 
devoted  to  books  and  writing.  He  however 
attended  lectures  on  different  subjects,  but  par- 
ticularly and  carefully  two  long  courses  by  M. 
Andral.  Yet  his  attendance  on  hospitals  would 
seem  alone  to  have  afforded  him  sufficient  occu- 
pation ;  while,  except  his  notes  of  cases,  the 
occupations  above-mentioned  could  not  have  been 
carried  on  except  at  his  lodgings.  The  time 
spent  by  him  in  hospitals  while  in  Paris,  a  period 
of  eighteen  months,  was  not  less  than  five  hours 
a  day,  and  for  many  months  it  amounted  to  six 
and  seven  hours  a  day.  This  time  too  was  not 
spent  in  a  holiday  service  ;  a  large  part  of  it 
was  occupied  in  examining  cases  for  himself, 
strictly  scrutinizing  their  history  by  the   interro- 


JAMES    JACKSON,    JR.  69 

gation  of  patients  and  by  examining  for  the 
physical  signs  of  disease  ;  and  a  portion  of  it 
almost  every  day  in  the  autopsy  room,  where, 
on  the  cold  and  wet  floors,  he  usually  tested  by 
his  personal  examination  all  the  minute  changes 
of  structure  to  which  disease  had  given  rise,  so 
as  to  have  become  perfectly  familiar  with  the 
common  chans'es  of  this  sort,  to  which  the 
human  body  is  liable.  In  thus  reviewing  his 
labors  it  seems  strange  that  he  could  find,  as  he 
did,  any  time  for  society,  for  exercise  and  for 
relaxation.  I  am  almost  tempted  to  blot  out  the 
lines  I  have  written  on  this  topic.  My  heart 
bleeds  almost  in  thinking  how  arduous  were  his 
labors  and  how  much  more  my  happiness  might 
now  be,  had  they  been  much  less  so.  I  believe 
the  statement  to  be  quite  within  the  truth,  and  it 
makes  a  part  of  his  history  ;  but  I  cannot  recom- 
mend to  any  young  man  to  follow  his  example, 
to  its  full  extent,  in  this  respect. 

In  the  enumeration  of  his  labors  while  abroad, 
I  have  omitted  to  notice  that  he  had  first  to 
acquire  the  art  of  speaking  the  French  language, 
which  he  could  not  do,  when  he  first  entered 
Paris,  and  for  which  he  devoted  two  hours  a  day 
for  some  weeks,  though  he  at  once  went  into  the 
hospitals  and  learned  to  talk  among  the  sick  ;  — 


70  MEMOIR    OF 

that  he  gave  a  portion  of  thne  to  the  study  of 
practical  anatomy  under  a  private  teacher  ;  that 
he  attended  to  instruction  on  obstetrics,  and  con- 
nected himself  with  three  private  institutions  at 
the  same  time,  so  as  to  increase  his  opportuni- 
ties for  practice  in  this  branch ;  and  that  he 
devoted  one  whole  month  industriously  in  Lon- 
don to  the  copying  and  arranging  his  cases  of 
cholera,  which  formed  a  book  in  octavo  of  two 
hundred  pages  ;  and  lastly,  that  his  whole  sum- 
mer in  Great  Britain  was  spent  in  travelling, 
conversing  with  medical  men,  not  idle  conversa- 
ion,  and  in  a  critical  study  of  their  collections  of 
preparations  of  comparative  and  morbid  anatomy. 

Of  the  professional  acquirements,  which  were 
the  fruits  of  his  industry  at  home  and  abroad,  I 
have  perhaps  said  enough  ;  but  I  am  tempted 
to  point  out  more  particularly  what  those  acquire- 
ments w^ere  ;  the  more,  as  I  think  his  attention 
was  directed  to  the  points  which  a  medical  stu- 
dent should  principally  regard. 

Every  thinking  physician  finds  more  and  more 
as  he  gains  experience,  that  his  greatest  difficulty 
is  in  what  we  term  the  diagnosis  and  the  prog- 
nosis. He  wishes  to  ascertain  by  examining  his 
patient  precisely  what  is  his  present  difficulty, 
and  what  course  his  disease  is  likely  to  pursue. 


JAMES    JACKSON,    JR.  71 

He  wishes  in  short,  to  be  acquamted  with  every- 
thing, which  goes  into  the  natural  history  of 
diseases.  For  this  purpose  he  finds  the  specula- 
tions of  the  closet  as  useless  as  such  speculations 
would  be  to  a  gardener,  who  should  desire  to 
know  one  plant  from  another  and  the  manner  of 
gro^vth  of  each.  Further,  to  understand  the 
natural  history  of  diseases,  he  must  have  a  know- 
ledge of  what  appertains  to  the  living  body  in 
health ;  in  other  words,  of  physiology.  Facts 
and  facts  only  are  useful  to  him.  Close  obser- 
vation alone  will  serve  his  purpose.  It  is  some- 
times not  until  after  the  experience  and  disap- 
pointment of  years,  that  the  physician  fully 
realizes  all  this  ;  but  if  he  is  an  honest  and  intel- 
ligent seeker  for  truth,  he  discovers  it  more  or 
less  clearly  at  last. 

Impressed  as  I  have  long  been  with  these 
principles,  it  will  be  supposed  that  I  endeavored 
to  fix  them  in  my  son's  mind.  He  was  willing 
to  receive  them  and  soon  came  under  their  full 
influence.  But  it  was  away  from  me  that  he 
learned  how  to  apply  them  more  rigorously 
and  with  the  greatest  benefit.  This  he  did 
from  M.  Louis  ;  who,  I  hesitate  not  to  say,  has 
been  the  most  successful  as  well  as  the  most 
rigorous,  in  pursuing  this  mode  of  studying  dis- 


72  MEMOIR    OF 

ease,  of  any   physician   in   ancient   or   modern 
times. 

The  resuh  was,  as  respects  my  son,  that  he 
returned  to  this  country  already  possessed  of 
uncommon  skill  for  his  age,  in  the  examination 
of  cases  of  disease  and  in  distinguishing  in  each 
case  the  actual  morbid  affection  ;  and  also  well 
taught  in  the  best  mode  of  pursuing  his  investi- 
gations, so  as  to  promote  the  cause  of  true  science. 
In  the  examination  of  the  thorax  by  percussion 
and  auscultation  he  was  peculiarly  well  versed, 
as  likewise  with  the  diseases  of  this  region  of 
the  body.  He  was  also  familiar  with  the  vari- 
ous morbid  changes,  to  which  the  several  organs 
and  textures  are  liable.  Wlien  he  went  to 
France,  I  urged  upon  him  the  importance  of 
getting  a  knowledge  of  the  morbid  changes,  to 
which  the  various  membranes,  and  particularly 
those  of  the  alimentary  canal,  are  subject.  In 
no  other  place  could  this  knowledge  be  obtained 
so  perfectly.  The  occurrence  of  the  cholera  in 
that  country  furnished  at  once  occasion  and 
inducements  to  pursue  these  inquiries,  as  to  the 
alimentary  canal ;  and  he  did  so  with  success. 
He  did  not  overlook  the  morbid  changes  which 
occur  in  the  brain  and  in  other  parts.  But  he 
seemed  early  to  fix  upon  the  thorax  as  the  sub- 


JAMES    JACKSON,    JK. 


75 


ject  of  his  particular  study.  He  was  led'  to 
this,  perhaps,  by  my  frequent  remarks  on  the 
obscurity  of  the  diseases  of  this  great  cavity  in 
many  instances,  and  on  the  large  proportion  of 
cases  in  which  they  were  fatal. 

He  was  not  ignorant  of  the  common  methods 
of  treating  diseases  both  in  this  country  and  in 
Europe,  though  less  informed  as  to  the  reputed 
virtues  of  some  medicines  than  many  others. 
But  he  considered  therapeutics  as  a  branch  of 
medical  science  which  he  had  yet  to  study.  He 
was  very  sceptical  as  to  the  utility  of  many 
practices  commonly  adopted,  believing  that  they 
rested  on  insufficient  authority,  and  he  wished 
to  bring  them  to  the  test  of  experiment.  He  did 
not  feel  a  reliance,  in  respect  to  the  influence  of 
medicine,  on  the  experience  of  men,  who  could 
not  tell  what  would  be  the  result  of  a  disease 
without  the  use  of  remedies.  He  was  never- 
theless ready  to  follow  to  a  certain  extent  the 
course  adopted  by  physicians  of  sound  judgment, 
until  he  should  have  opportunities  to  decide  by 
his  own  experience.  For  his  scepticism  there 
certainly  is  some  ground  in  the  actual  state  of 
our  science ;  and,  if  either  extreme  must  be 
chosen,  I  would  advise  a  young  physician  to 
adopt  the  expectant   mode   of  treatment,  recom- 


74 


MEMOIR    OF 


mended  by  some  physicians  of  France,  rather 
than  to  employ  on  every  occasion  the  heroic 
remedies  of  some  of  our  countrymen.  The  pro- 
fuse use  of  these  remedies,  and  the  abundant 
use  of  even  mild  articles  in  endless  combinations, 
too  often  witnessed  among  us,  cannot  be  too 
openly,  nor  too  loudly  reprobated.  These  errors 
are  disgraceful  to  our  profession.  But,  if  that 
were  all,  one  might  be  silent.  They  cause  need- 
less and  often  great  suffering  to  those,  who  are 
already  afflicted  enough. 

At  the  suggestion  and  request  of  one  of  my 
most  judicious  brethren,  I  shall  add,  that  my 
son's  influence  on  the  profession  here,  in  the 
short  time  he  was  with  us,  was  of  a  very  salu- 
tary description.  This  gentleman  states  that 
my  son  not  only  caused  others,  who  had  not  yet 
read  the  works  of  M.  Louis,  to  study  them  with 
care ;  but  that  he  induced  among  the  rising 
members  of  the  profession  in  our  own  city  the 
habits  of  thorough  observation  of  the  phenome- 
na of  disease  in  the  living  and  in  the  dead, 
which  he  had  learned  from  the  same  great  pathol- 
ogist. He  also  taught  us  much  in  respect  to  the 
physical  signs  of  disease  in  the  thorax,  with 
which  we  were  imperfectly  acquainted  before  ; 
at  least  I  may  say,  this  was  true  as  to  myself. 


JAMES    JACKSON,    JR.  75 

Indeed  I  ought  to  say  more  ;  for  he  aided  me 
very  much  in  regard  to  the  diagnosis  of  the 
more  obscure  diseases  of  that  region,  derived 
from  the  combination  of  the  physical  and  rational 
signs.  On  emphysema  of  the  lungs  he  threw, 
for  me,  quite  a  new  light. 

These  good  impressions  will  not  be  lost.  Al- 
ready we  have  with  us  one  of  his  fellow  students 
under  M.  Louis,  who  is  abundantly  able  and 
will  not  fail  to  keep  them  alive.  And  others  are 
soon  to  follow,  who  will,  I  am  sure,  carry  forward 
the  good  work  with  the  same  disinterested  love 
for  science. 

I  have  mentioned  the  sensibility  of  my  son 
to  the  kindness  he  had  experienced  from  his 
friends  during  his  fever.  I  cannot  close  this 
memoir  without  some  notice  of  the  extent  of 
that  kindness.  It  was  in  truth  so  great  that 
I  never  stated  to  him  the  full  amount  of  it ; 
waiting  till  he  should  recover  more  strength  and 
be  better  prepared  to  acknowledge  it.  While  his 
life  was  thought  to  be  in  danger,  not  only  friends 
and  neighbors,  but  those  who  were  personally 
strangers  to  me,  manifested  a  great  interest  in 
his  welfare  and  the  utmost  readiness  to  afford  to 
him  and  to  me  any  assistance  in  their  power. 
Every  aid  was  proffered  from  the  most  respecta- 


76  MEMOIR    OF 

ble  sources  ;  and  my  son  had  for  his  night- 
watchers,  during  all  the  critical  period  of  his 
disease,  the  most  busy  and  most  experienced 
physicians  of  our  city.  So  great  indeed  was  the 
public  sj^mpathy  on  this  occasion,  that  I  could 
not  consent  to  have  it  roused  again  in  his  last 
illness  ;  and  hence  I  represented  his  case  to  all, 
except  my  most  intimate  friends,  in  the  brightest 
possible  colors.  I  cannot  omit  to  make  this  ac- 
knowledgment of  favors  which  I  can  never  repay, 
though  its  statement  involves  so  much  of  egotism. 
I  would  say  something  of  the  religious  princi- 
ples of  my  son.  He  began  early  to  look  at  reli- 
gion with  real  solemnity,  yet  without  fear.  At 
the  very  outset  he  acquired  a  conviction  of  and 
a  confidence  in  the  unbounded  goodness  of  his 
Maker.  It  is  from  the  views  adopted  on  this 
fundamental  point,  whence  issues  so  much  light, 
that  the  religious  principles  of  most  persons  take 
their  color.  He  could  love  and  did  love  supremely 
the  Father  of  all  things.  He  loved  w^ith  fear,  a 
fear  that  he  himself  should  do  wrong ;  but  he 
loved  also  with  confidence.  He  listened  with 
delight  to  those  instructions  from  the  pulpit, 
which  called  on  him  to  think  worthily  of  his  own 
nature,  that  he  might  act  in  accordance  with  it. 
The  sublime  character  of  our    Saviour   and   of 


JAMES    JACKSON,  JR.  77 

his  teachings  was  regarded  by  his  heart,  as  well 
as  his  mind,  with  the  greatest  possible  respect. 
He  viewed  that  character  and  those  teachings  as 
strono:  evidence  of  his  mission  from  God.  In 
regard  to  the  external  evidence  he  saw  that  it  re- 
quired long  and  careful  study,  which  every  man 
could  not  undergo.  He  was  willing  to  believe 
that  it  was  sufficient,  on  good  authority,  until  he 
should  be  able  to  examine  it  for  himself.  He 
would  not  however  profess  to  believe,  as  if  he 
had  already  exaniined  it.  Meanwhile  he  enter- 
tained no  fears  of  death  ;  satisfied  perfectly  that 
that  event  would  be  decided  by  wisdom  beyond 
his  comprehension.  Such,  almost  literally,  were 
the  sentiments  which  he  expressed  to  me,  shortly 
before  the  first  sickness,  of  which  I  have  given 
an  account. 

With  such  characteristics  as  I  have  attributed 
to  my  son,  he  seemed  calculated  to  be  highly 
useful  in  the  world.  I  never  anticipated  that  he 
would  have  a  commanding  influence  in  society, 
but  I  did  think  that  he  would  have  an  agreeable 
and  useful  influence.  Why  he  should  have 
been  permitted  to  go  so  far,  to  give  blossoms  of 
so  fair  a  promise  and  of  so  sweet  a  flavor,  and 
just  then  be  cut  down,  it  is  not  for  us  to  say.  It 
is  one  of  those  events,  which  show  us   that  we 


78  ME  Mom. 

know  very  little  of  the  designs  of  our  own 
being,  at  least  while  we  regard  this  world  only. 
I  do  not  consider  it  as  singular,  because  to  me  it 
was  so  afflictive  ;  because  I  was  disappointed  of 
the  most  cherished  hopes,  just  when  I  was  almost 
ready  to  think  my  life  well  spent  in  having 
learned  how  to  educate  one,  who  could  be  much 
more  useful  than  I  had  ever  been.  I  need  not 
look  far  from  home  to  find  those  who  suffered  in 
like  manner,  almost  at  the  same  moment.  The 
instance  is  not  singular ;  and  because  it  is  not, 
we  must  infer  that  the  end  of  our  existence  is 
not  merely  to  be  useful  in  this  world  ;  and  we 
must  be  comforted  by  the  assurance  that  a  good 
life,  however  short,  is  the  great  blessing  which 
alone  should  satisfy  all  our  desires,  as  respects 
our  children.  Almost  unnatural  it  may  seem, 
at  least  against  the  ordinary  course  of  nature,  for 
a  father  thus  to  erect  a  monument  for  his  son. 
But  surely  he  should  be  solaced,  if  the  life  of  his 
son  has  furnished  at  once  the  solid  materials  for 
its  erection  and  flowers  for  its  ornament. 


NOTES   TO   THE   MEMOIR 


Note  A.— Page  33 


It  is  due  perhaps  to  M.  Louis  to  state  why  his 
urgent  advice  in  respect  to  my  son's  course  of 
life  was  not  adopted  by  us.  I  will  first  mention 
that  I  left  my  son  to  decide  for  himself,  only 
placing  before  him  the  objections  which  I  saw 
to  the  plan  proposed  by  his  excellent  and  wise 
friend.  This  I  communicated  to  him,  while 
abroad,  desiring  only  that  he  would  not  decide, 
until  after  his  return.  It  was  not  long  after  his 
return  that  he  decided  that  he  could  not  adopt 
M.  Louis's  plan  in  its  full  extent,  but  he  deter- 
mined  to  conform  to  it  as  far  as  he  should  find 
practicable,  and  I  was  very  ready  to  aid  him  in 
so  doing.  He  decided  to  engage  in  business, 
but  to  take  no  pains  to  be  fully  engaged  in  it,  and 
thought  that  for  several  years  he  could  be  occu- 


so  NOTES 

pied  principally  in  the  course    of  observation,  on 
which  he  had  already  entered. 

But  why  could  he  not  adopt  the  plan  fully  ? 
Because  in  this  country  his  course  would  have 
been  so  singular,  as  in  a  measure  to  separate 
him  from  other  men.  We  are  a  business  doing 
people.  We  are  new.  We  have,  as  it  were, 
but  just  landed  on  these  uncultivated  shores  ; 
there  is  a  vast  deal  to  be  done ;  and  he  who  will 
not  be  doing,  must  be  set  down  as  a  drone.  If 
he  is  a  drone  in  appearance  only  and  not  in  fact, 
it  will  require  a  long  time  to  prove  it  so,  when 
his  character  has  once  been  fixed  in  the  public 
mind. 

This  view  of  the  subject  is  too  vague,  at  least 
for  those  who  belong  to  other  and  older  coun- 
tries. Let  me  then  state  the  matter  more  defi- 
nitely. Among  us,  w^here  the  hands  are  yet 
few  in  proportion  to  the  work  to  be  done,  every 
young  man  engages  as  soon  as  he  can  in  the 
business  of  life.  The  public  estimation  of  his 
character  is  decided  early  in  his  life ;  earlier 
than  in  Europe.  In  our  learned  professions  men 
certainly  come  forward  too  young  in  most  instan- 
ces. They  do  not  ordinarily  keep  at  work  so 
long,  nor  do  their  work  so  well,  as  if  they  had 
made  more  thorough  preparation  for  it.     But,  if 


TO  THE  me:.ioir.  81 

an  individual  were  to  go  very  far  in  the  other 
extreme,  his  reputation  would  be  fixed,  as  one, 
who  perhaps  loved  knowledge  and  knew  how  to 
acquire  it ;  but  who  was  not  disposed  to  use  it, 
and  who  perhaps  did  not  know  how  to  apply  it. 
Most  of  our  physicians  go  into  business  after 
three  years  of  study  ;  some,  by  visiting  foreign 
schools,  protract  the  period  of  study  to  five  or 
six  years.  If  now,  after  this  longer  period,  one 
shoald  at  the  present  day,  spend  four  or  five 
years  longer  in  the  acquisition  of  professional 
knowledge,  before  he  should  begin  to  engage  in 
professional  business,  and  this  in  the  society 
where  he  meant  ultimately  to  be  so  engaged,  he 
ivould  be  regarded  as  a  singular  being,  governed 
by  a  peculiar  taste  ;  and  it  would  probably  be 
thought  that  he  would  never  be  fit  for  the  active 
business  of  life.  He  might  become  a  teacher 
and  attract  pupils,  but  he  might  find  it  difiicult 
to  get  patients. 

In  Europe  it  would  not  be  so  ;  but  at  present 
iny  fears  would  be  that  such  would  be  the  result 
in  this  country.  It  should  be  added,  that  my  son 
like  most  other  professional  men  among  us, 
necessarily  looked  to  his  own  labors  for  his 
support.  I  should  with  great  pleasure  have 
supported  him,  while  going  through  his  four  or 
6 


82  NOTES 

five  years  of  medical  observations.  But  I  could 
not  give  him  the  means  of  support  for  life,  be- 
cause I  had  not  them  to  give.  He  must  then, 
at  the  end  of  those  years,  have  come  forward  as 
a  candidate  for  practice,  with  young  men  who 
had  started  in  life  many  years  after  him  ;  while 
his  former  companions  would  be  already  immers- 
ed in  business,  and  could  hardly  sympathize 
with  him  in  any  respect.  He  would  be  regarded 
as  in  a  false  position  because  he  was  in  a  singular 
one  ;  and  because  so  regarded,  he  would  be  kept 
there.  He  w'ould  come  forward  with  the  habits 
and  feelings  of  a  student,  while  his  early  com- 
panions would  have  acquired  the  habits  of  men 
of  business.  In  this  way  he  would  both  fail  lo 
obtain  a  support  for  himself,  and  fail  to  be  useful 
to  others.  He  would  have  acquired  the  habit 
of  dependence  on  others,  instead  of  that  habit  of 
dependence  on  one's  self  for  support,  \vhich  in 
this  country  seems  almost  necessary  for  every 
man.     Such  at  least  were  my  fears. 

It  was  from  considerations  of  this  sort  that  I 
hesitated  to  encourage  the  plan  proposed  by  M. 
Louis  to  my  son.  He  himself  saw  the  subject 
in  the  same  light,  and,  though  with  reluctance, 
relinquished  the  plan.  Perhaps  we  were  both 
too  timid.     I  now  advert  to  the  subject  to  show, 


TO    THE    MEMOIR.  83 

that  we  did  not  refuse  to  follow  the  advice  of  his 
excellent  friend,  without  a  consideration  of  it. 


Note  B.  —  Page  41. 

'  I  am  not  willing  to  mention  the  names  of  pri- 
vate individuals,  to  whom  my  son  had  the  honor 
of  being  introduced ;  nor  to  adduce  evidence  of 
the  claims  to  much  more  praise  than  I  have  giv- 
en, on  the  part  of  the  select  circle,  among  whom 
he  was  admitted  as  a  friend  in  London.  One 
circumstance  only  I  shall  state  which  may  be 
regarded  by  many  as  such  evidence,  and  I  state 
this  partly  for  the  sake  of  a  quotation  from  my 
son's  letter  of  June  12th,  which  relates  to  this 
circle.  It  is  that  in  this  same  circle,  the  Rajah, 
Ram  Mohun  Roy,  was  in  the  habit  of  visiting 
familiarly  and  unceremoniously,  like  an  old 
friend.  My  son  speaks  of  his  introduction  to 
this  most  excellent  Hindoo  as  among  the  benefits 
w^hich  were  conferred  on  him  by  one  of  his 
friends  ;  and  subsequently  adds  substantially  as 
follows  :  "  When  I  reflect  upon  the  character  and 
regard  the  lofty  front  and  nobly  intelligent  and 
benevolent  countenance,  which,  could  it  but  be  in 


84  NOTPIS 

the  station,  would  almost  exercise  the  influence 
of  a  moral  sun,  and  read  the  works  of  Ram 
Mohun  Roy,  and  then  remember  that  I  was  born 
in  an  enlig-htened  and  he  in  an  unenlightened 
country,  I  blush  for  my  own  imperfections  and 
make  resolutions  for  the  future.  A  new  feeling, 
a  new  passion  has  been  awakened  in  me.  '^  ^ 
It  \vill  be  the  object  of  my  life,  not  singly,  but 
much  more  than  it  would  have  been  had  I  not 
seen  this  circle,  to  aid  in  the  work  to  spread 
knowledge  and  happiness." 


Xote  C—  Page  19. 


P.  Ch.  A.  Louis,  physician  of  the  Hospital  de 
la  Pitie,  is  a  man,  whose  labors  and  whose  writ- 
ings must  become  more  and  more  known  for  ages. 
I  should  deem  it  service  enough  to  my  brethren 
in  this  country,  if  I  could  induce  them,  one  and 
all,  to  read  and  to  study  the  works  of  this  great 
pathologist.  M.  Louis  is  the  founder  of  the  nu- 
merical system,  as  it  has  been  denominated,  in 
respect  to  the  science  ( f  medicine.  It  is  the  ob- 
ject of  this  note  to  state  what  that  system  is,  and 


TO    THE    MEMOIR.  85 

briefly  to  advert  to  the  successful  application  of 
it  by  its  founder. 

How  many  will  be  ready  to  turn  aside,  when 
they  hear  of  a  new  system.  Has  not  system 
followed  system,  it  will  be  asked,  ever  since  the 
days  of  the  four  humors  ?  Facts,  it  will  be  added, 
observations,  exact  observations  are  wanting,  not 
systems,  in  order  to  carry  forward  the  science 
of  medicine.  Be  it  so;  it  is  the  last  point  on 
which  I  would  disagree  with  my  reader.  If, 
however,  that  reader  has  not  had  much  experi- 
ence on  the  subject,  he  may  not  be  aware  of  the 
difficulty  of  making  good  observation,  as  regards 
both  pathology  and  therapeutics,  and  of  the  cau- 
tion which  is  requisite  in  m.aking  deductions. 
These  difficulties  should  not  deter  us  from  adopt- 
ing the  right  course  ;  they  should  only  make  us 
study  to  find  out  what  this  course  is.  M.  Louis 
certainly  will  not  direct  us  to  turn  from  observa- 
tion to  speculation. 

But  to  remove  the  objection,  let  me  say  at 
once  that  M.  Louis  has  not  brought  forward  a 
new  system  of  medicine  ;  he  has  only  proposed 
and  pursued  a  neiv  method  in  prosecuting  the 
study  of  medicine.  This  is  nothing  else  than 
the  method  of  induction,  the  method  of  Bacon, 
so   much   vaunted   and   yet   so    little  regarded. 


86  NOTES 

But,  if  so,  where  is  the  novehy  ?  If  any  one, 
after  patiently  studying  and  practising  the  method 
proposed  by  M.  Louis,  denies  the  noveUy  of  it, 
I  will  not  dispute  with  him  a  moment.  Perhaps 
he  will  then  agree  with  me  that  it  is  a  novelty  to 
pursue  the  method  of  Bacon  thoroughly  and 
truly  in  the  study  of  medicine ;  though  it  is  not 
new  to  talk  of  it  and  to  laud  it. 

A  little  history  of  one  part  of  M.  Louis's  life 
will  throw  some  light  on  this  subject.  This  gen- 
tleman went  abroad,  and  I  believe  had  some 
appointment  in  Russia,  after  he  had  gone  through 
the  usual  course  of  professional  education.  Re- 
turning to  France  at  the  age  of  thirty  two,  he  was 
about  to  engage  in  private  practice.  He  was  then 
led  to  examine  anew  the  state  of  the  science  of 
medicine,  and  was  dissatisfied  with  it.  He  now 
decided  to  abandon  the  thoughts  of  practice  for 
a  time,  and  to  devote  himself  to  observation ; 
that  is,  to  the  study  of  medicine,  as  it  actually 
presents  itself.  With  this  view  he  went  into 
the  Hospital  la  Charitc  in  Paris,  and  followed 
the  practice  of  M.  Chomel,  now  a  physician  at 
the  Hotel  Dieu  and  Professor  of  Clinical  Medi- 
cine, and  highly  esteemed  as  an  author.  M. 
Louis  passed  nearly  seven  years  in  studying  med- 
icine in  this  way.     The  first  part    of  this  time 


TO    THE    MEMOIR.  87 

he  was  learning  how  to  make  observations. 
When  he  thought  he  had  attained  this  art,  he 
threw  away,  as  I  have  understood,  the  notes  he 
had  already  collected,  and  began  anew  to  accu- 
mulate exact  observations  of  the  phenomena 
presented  by  the  sick  and  of  those  derived  from 
an  examination  after  death  in  the  fatal  cases. 
In  this  course  of  observation  he  did  not  make  a 
selection  of  cases,  but  took  them  as  they  were 
presented,  indiscriminately.  He  was  not  in  a 
hurry  to  make  deductions  from  his  cases,  satis- 
fied that  he  was  gathering  the  materials,  from 
which  truth  must  ultimately  be  elicited.  He 
was  only  careful  that  his  observations  should  be 
correct,  and  had  not  any  general  principles  or 
doctrines,  for  which  he  sought  support,  or  con- 
firmation. 

To  estimate  the  value  of  his  observations,  it 
is  necessary  to  understand  the  plan,  on  which 
he  collected  them.  First,  then,  he  ascertained 
when  the  patient  under  his  examination  began 
to  be  diseased.  Not  satisfied  with  vague  answers 
he  went  back  to  the  period,  when  the  patient 
enjoyed  his  usual  health  ;  and  he  also  endeav- 
ored to  learn  whether  that  usual  health  had  been 
firm,  or  in  any  respect  infirm.  He  noted  also 
the    age,  occupation,  residence,  and    manner    of 


88  NOTES 

living  of  the  patient ;  likewise  any  accidents 
which  had  occurred,  and  which  might  have  influ- 
enced the  disease  then  affecting  him.  He  ascer- 
tained also,  as  much  as  possible,  the  diseases 
which  had  occurred  in  the  family  of  his  patient. 
Secondly,  he  inquired  into  the  present  disease, 
ascertaining  not  only  what  symptoms  had  marked 
its  commencement,  but  those  which  had  been 
subsequently  developed  and  the  order  of  their 
occurrence  ;  and  recording  those,  which  might 
not  seem  to  be  connected  with  the  principal  dis- 
ease, as  well  as  those  which  were  so  connected  ; 
also,  measuring  the  degree  or  violence  of  each 
symptom  with  as  much  accuracy  as  the  case 
would  admit.  Thirdly,  he  noted  the  actual 
phenomena  present  at  his  examination,  depend- 
ing for  this  not  only  on  the  statement  of  the 
patient,  but  on  his  own  senses,  his  eyes,  his  ears 
and  his  hands.  Under  this  and  the  preceding 
head  he  was  not  satisfied  with  noting  the  func- 
tions, in  which  the  patient  complained  of  disor- 
der, but  examined  carefully  as  to  all  the  functions, 
recording  their  state  as  being  healthy  or  otherwise 
and  even  noticing  the  absence  of  symptoms,  which 
might  bear  on  the  diagnosis.  Thus  all  secondary 
diseases,  and  those  which  accidentally  co-existed 
with  the  principal  malady,  were  brought  under 


TO    THE    MEMOIR.  89 

his  view.  Fourthly,  he  continued  to  watch  his 
patient  from  day  to  day,  carefully  recording  all 
the  changes  which  occurred  in  him  till  his  resto- 
ration to  health,  or  his  decease.  Fifthly,  in  the 
fatal  cases  he  exercised  the  same  scrupulous  care 
in  examining  the  dead,  as  he  had  in  regard  to 
the  living  subject.  Prepared  by  a  minute  acquain- 
tance with  anatomy,  and  familiar  with  the  chan- 
ges wrought  by  disease,  he  looked  not  only  at  the 
parts  where  the  principal  disorder  was  manifest- 
ed, but  at  all  the  organs.  His  notes  did  not  state 
opinions,  but  facts.  He  recorded  in  regard  to 
each  part,  which  was  not  quite  healthy  in  its 
appearance,  the  changes  in  color,  consistence, 
firmness,  thickness,  &c. ;  not  contenting  himself 
with  saying  that  a  part  was  inflamed,  or  was 
cancerous,  or  with  the  use  of  any  general,  but 
indefinite  terms. 

Without  presuming  that  I  have  described  in 
the  most  exact  manner  the  course  pursued  by 
M.  Louis,  I  have  said  enough  to  make  his  plan 
inelligible  to  men  of  sagacity.  Others  have  taken 
down  cases  in  like  manner.  In  the  first  volume 
of  the  "  Transactions  of  a  Society  for  the  Im- 
provement of  Medical  and  Chirurgical  Know- 
ledge," published  1793,  there  is  a  paper  by  Dr 
Fordyce,  entitled,  "  An  attempt    to    improve  the 


90 


NOTES 


evidence  of  medicine."  In  this  paper  Dr  For- 
dyce  recommends  the  careful  collection  of  cases, 
as  the  only  foundation  for  the  improvement  which 
he  wished  to  see.  Dr  Fordyce  goes  into  many 
details,  and  gives  two  cases  in  a  tabular  form  by 
way  of  illustration,  and  states  that  he  has  many 
cases  collected  upon  this  plan.  In  his  plan  some 
matters  are  insisted  upon  more  than  by  M.  Louis 
perhaps  ;  others  less.  But  Dr  Fordyce  does  not 
insist  upon  the  examination  after  death,  a  most 
important  part  of  the  plan  adopted  by  M.  Louis. 
If  however  the  attempt  proposed  had  been  fol- 
lowed by  vigorous  efforts,  most  important  ben- 
efits would  have  resulted  from  it.  Many  no 
doubt  thought  of  doing  it.  I  myself  thought 
seriously  of  it  more  than  thirty  years  ago,  and 
had  blanks  printed  for  my  cases  according  to  the 
plan  of  Fordyce.  But  the  difficulties  attending 
the  plan  in  private  practice  discouraged  me  too 
soon.  So  far  as  I  have  known,  M.  Ljuis  is  the 
only  physician  who  has  devoted  himself  for 
years  together,  at  a  mature  age  and  after  a  suffi- 
cient education,  to  simple  observation,  without 
the  distraction  of  medical  practice,  and  without 
having  any  share  in  the  treatment  of  the  cases 
under  his  observation. 

It  was  only  when  he  had  accumulated  a  great 


TO    THE    ME3I0IR.  91 

mass  of  cases,  that  M.  Louis  began  to  deduce 
from  ihem  any  general  principles.  He  then 
arranged  the  facts  he  had  collected  in  a  tabular 
form,  so  as  to  facilitate  a  comparison  of  them. 
How  much  labor  this  required  will  be  in  some 
measure  conceived,  when  I  state  that,  while  going 
through  one  class  of  his  observations,  those,  I 
believe,  which  relate  to  acute  diseases,  he  retired 
to  a  distance  from  Paris  and  occupied  ten  months 
in  making  out  his  tables.  This  statement  is,  I 
believe,  substantially,  if  not  precisely  correct. 

Let  the  reader  conceive  of  these  tables  draA\ii 
out  with  accuracy,  having  columns  devoted,  with 
proper  discrimination,  to  each  function  and  to  its 
various  derangements,  as  manifested  during  life, 
and  to  each  organ  and  its  lesions  as  ascertained 
after  death  ;  let  him  then  go  to  these  tables  and 
inquire,  under  what  circumstances  certain  signs 
of  disease  arise,  and  with  what  pathological 
changes  in  the  dead  body  they  are  found  to  cor- 
respond ;  let  him  ask  under  what  circumstances 
certain  morbid  changes  of  structure  occur,  and 
with  what  symptoms  they  are  found  to  be  con- 
nected ;  he  may  find  the  answers  and  he  may 
obtain  them  numerically.  That  is,  he  m.ay  learn 
in  hoAV  many  cases  out  of  a  hundred  of  any 
particular  disease  he  will  find  a  certain  derange- 


92 


NOTES 


ment  of  a  particular  function,  or  a  certain  change 
in  structure  of  a  particular  organ  ;  and  he  may 
also  learn  how  often  the  same  things  may  be 
noticed  in  other  diseases,  with  which  that  under 
consideration  may  be  compared.     ^     ^-     ^ 

The  experience  of  one  man  is  necessarily  lim- 
ited, and  more  extensive  researches  may  give 
results  different  from  those  at  which  M.  Louis 
has  arrived.  But  I  am  disposed  to  think  that 
the  difference  will  not  be  material  in  many  instan- 
ces. His  observations  were  made  only  in  the 
hospitals  of  Paris.  Other  observations  made  in 
different  climates  and  among  persons  of  different 
habits,  will  probably  discover  differences  of  some 
kind,  and  perhaps  some  which  are  material.  But 
in  most  respects,  since  the  works  of  M.  Louis 
have  been  known  to  me,  I  have  found  his  obser- 
vations confirmed  by  my  experience  here ;  and 
indeed  in  many  respects  they  accord  with  my 
own  previous  observations,  being,  however,  more 
precise  than  mine  had  been.     #     =?^     ^     ^ 

I  am  not,  however,  engaged  in  reviewing  the 
works  of  M.  Louis.  I  have  not  guarded  myself 
in  all  points  in  stating  his  observations.  I  wish 
to  induce  others  to  read  his  books,  and  they  will 
then  see  the  prudent  caution,  with  which  he 
offers    all  general   remarks,  and  the  scrupulous 


TO    THE    MEMOIR.  93 

care  which  he  exercises  in  making  his  deduc- 
tions. He  studies  nature  with  a  full  faith  in  the 
uniformity  of  her  laws,  and  in  the  certainty  that 
truth  may  be  ascertained  by  diligent  labor.  It 
is  truth  only  he  loves  ;  not  anxious  to  build  up  a 
system,  nor  pretending  to  explain  everything,  he 
says  to  his  pupils.  Such  and  such  have  been  my 
observations ;  you  can  observe  as  well  as  I,  if 
you  will  study  the  art  of  observation,  and  if  you 
will  come  to  it  with  an  honest  mind,  and  be 
faithful  in  noting  all  which  you  discover,  and 
not  merely  the  things  which  are  interesting  at 
the  moment,  or  those  v\'hich  support  a  favorite 
dogma  ;  I  state  to  you  the  laws  of  nature  as 
they  appear  to  me  ;  if  true,  your  observations 
will  confirm  them  ;  if  hot  true,  they  will  refute 
them;  I  shall  be  content  if  only  the  truth  be 
ascertained. 

I  wish  to  add  that  M.  Louis  has  inspired  a 
gallant  band  with  his  spirit.  They  have  com- 
bined to  form  the  Society  of  Medical  Observa- 
tion at  Paris  ;  M.  Louis  is  their  President  and 
MM.  Chomel  and  Andral  are  the  Vice-Presidents. 
They  meet  to  report  their  observations  and  to 
be  corrected  by  each  other  and  by  their  president 
when  their  observations  are  inaccurate  or  defi- 
cient, or  when  their  inferences  are  broader  than 


94  NOTES 

their  premises.  The  members  are  selected  with- 
out reference  to  their  country  ;  they  are  from 
different  nations  ;  they  are  scattered,  and  will  in 
succession  be  scattered  over  the  world ;  and  all, 
who  carry  with  them  the  true  spirit,  must  con- 
tribute to  the  advancement  of  real  science.  Men 
who  devote  themselves  thoroughly  to  labor  in 
whatever  department,  must  be  felt  and  known  in 
society.  Let  the  members  of  this  society  go  on 
and  throw  the  fruits  of  their  labor  into  a  common 
stock,  and  they  must  all  of  them  be  enriched, 
and  all  around  them  be  enriched  at  the  same 
time.     ^     ^     =^     ^     ^ 

I  venerate  M.  Louis  greatly.  As  the  heir  of 
my  son  I  love  him  most  sincerely.  But  it  is  not 
with  the  vain  hope,  nor  even  with  the  desire  to 
promote  his  fame  by  my  feeble  commendations, 
that  I  have  written  this  note.  I  regard  it  as 
certain  that  his  fame,  and  what  he  will  regard 
much  more,  the  truths  which  he  has  discovered, 
will  be  extended  and  will  live  for  ages.  My 
sole  expectationis  to  lead  some,  who  might  other- 
wise be  ignorant  of  them,  among  my  brethren 
of  the  present  day,  to  study  works  which  I  esteem 
as  among  the  most  valuable  certainly,  if  not 
the  most  valuable,  which  any  age  has  furnished 
us  in  regard  to  medicine.     Unlike  the   systems, 


TO    THE    MEMOIR.  95 

which  are  always  spoken  of  in  the  history  of 
medicine,  as  successively  rising  with  splendor 
and  falling  into  oblivion,  the  principles  published 
by  the  founder  of  the  numerical  system  are  not 
an  artificial  network,  where  the  cutting  of  one 
thread  may  cause  the  whole  to  drop  away  ;  these 
principles  may  be  added  to,  they  may  be  enlarg- 
ed, limited  and  modified,  and  yet  the  system 
may  be  maintained  ;  and  it  will  still  derive  its 
support  from  the  first  labors  devoted  to  its  erec- 
tion as  much  as  from  the  last.  If,  for  instance, 
M.  Louis  has  observed  a  certain  symptom,  such 
as  the  enlargement  in  the  region  of  the  spleen, 
to  be  present  in  fortyfive  out  of  fifty  cases  of 
tj^phus ;  the  exceptions  will  be  ten  per  cent. 
Should  subsequent  observers  find,  that  in  a  hun- 
dred and  fifty  cases  there  have  been  twenty 
exceptions,  it  will  then  appear  that  these  in  the 
two  hundred  amount  to  twelve  and  a  half  per 
cent.  As  far  as  I  know,  there  are  very  few  of 
M.  Louis's  numerical  inferences,  which  have 
hitherto  required  to  be  modified  so  much  as  in 
the  instance  here  supposed,  since  the  publication 
of  his  great  works  ;  although  ten  years  have 
now  elapsed  since  that  on  phthisis  and  six  years 
since  that  on  typhus  was  published ;  and  although 
he  himself  has  continued,  during  this  period,  to 


96  NOTES 

devote  a  great  portion  of  his  time  to  the  collec- 
tion of  noAv  observations.  Were  it  otherwise, 
however,  it  would  be  glory  enough  for  one  man 
to  have  led  the  way  into  the  true  path,  and  to 
have  inspired  others  with  the  courage  to  follow 
him.  I  repeat  the  idea ;  —  it  is  the  spirit  of  bold 
and  hardy  enterprise,  which  is  the  glory  of  M. 
Louis. 

I  must  add  a  few  remarks  on  another  point. 
It  is  objected  by  some  to  the  labors  of  M.  Louis 
and  of  others  of  the  French  pathologists,  that 
they  labor  indeed  with  ardor  on  the  subject  of 
diagnosis,  that  the  study  with  they  zeal  of  ento- 
mologists to  discriminate  minute  changes  of 
structure  in  the  various  textures  of  the  human 
body,  but  they  do  nothing  to  advance  the  proper 
business  of  the  physician,  the  art  of  healing. 
Their  therapeutics  are  decried,  as  showing  an 
ignorance  of  what  has  been  thought  certain  in 
England  and  in  this  country  ;  and  they  them- 
selves are  regarded  even  as  indifferent  to  this 
branch  of  science.  Can  this  objection  need  a 
reply  ?  I  have  long  been  satisfied,  for  thirty 
years  I  have  been  satisfied,  that  the  physicians 
of  Paris  were  laying  the  firmest  foundation  for 
the  science  of  therapeutics,  by  studying  the  nat- 
ural history  of  diseases ;  and  by  thus  giving  us 


TO    THE    MEMOIR.  97 

rules  for  diagnosis  and  prognosis.  The  course 
they  have  pursued  has  not  always  been  the 
most  satisfactory,  and  one  at  least  among  them 
has  gone  over  to  the  dogmatic  philosophers, 
though  he  has  tried  to  disguise  his  desertion  of 
the  true  course.  But  the  course  they  have  pur- 
sued has  led  honest  spirits  to  be  more  and  more 
exact  in  their  observations,  until  now,  when  one 
has  arisen,  who  has  vigorously  undertaken  all 
the  toils,  to  which  the  method  previously  adopted 
would  rightly  lead  them.  Let  them  proceed  in 
the  same  spirit,  aided,  but  without  any  spirit  of 
rivalry,  by  the  pathologists  of  other  countries  ; 
let  us  all  learn  what  may  be  looked  for,  when  art 
does  not  interfere  in  the  diseases  of  the  human 
body ;  that  is,  let  us  study  the  rules  of  prognosis 
which  are  only  inferences  from  the  natural  his- 
tory of  diseases  ;  then  we  shall  be  prepared  to 
study  therapeutics.  Let  M.  Louis,  or  men  like 
him,  test  the  effect  of  remedies  in  the  same  spirit, 
with  which  he  has  pursued  his  pathological 
researches.  Having  determined  the  average 
duration,  fatality,  &c.,  of  typhus,  for  example, 
by  an  observ^ation  of  a  sufficient  number  of  cases 
through  a  series  of  years,  such  cases  not  having 
been  actively  treated,  let  him  then  employ  in 
the  same  disease  the  different  remedies  which 
7 


98  NOTES 

have  been  thought  useful.  One  physician  extols 
the  advantages  of  bleeding ;  another  commends 
antimonials  employed  on  the  lEirst  days  of  the 
disease,  in  emetic  doses,  and  for  a  few  days 
afterwards  in  doses  just  short  of  nauseating; 
another  contends  that  cinchona  is  the  best  anti- 
dote to  the  deadly  tendencies  of  this  malady. 
Let  each  mode  of  treatment  have  its  fair  trial ; 
and  let  the  results  be  compared  with  each  other 
and  with  similar  cases,  treated  at  the  same  time 
upon  the  expectant  method. 

This  is  substantially  the  mode,  in  which  ques- 
tions in  therapeutics  are  beginning  to  be  treated 
in  Paris.  So,  no  doubt,  they  have  been  treated 
elsewhere.  But  it  is  in  proportion  as  we  arrive 
at  precision,  in  respect  to  the  natural  history  of 
diseases,  that  this  mode  will  be  pursued  with  the 
greatest  advantage.  It  is  because  we  are  ap- 
proaching to  that  precision  that  I  think  it  scarcely 
rash  to  predict,  that  in  fifty  years  the  art  of  heal- 
ing will  be  grounded  on  many  exact  rules,  which 
we  and  our  predecessors  have  not  known.  These 
rules  will  not  be  brought  forward  as  derived  from 
grand  principles  of  physiology,  or  pathology ; 
they  must  be  deduced  from  the  aggregate  of 
careful,  faithful  observations  of  individual  facts, 
made  by  men  of  enlightened  minds.     A  love  of 


TO    THE    MEMOIR.  99 

truth,  an  unflinching   love    of  truth  is  the  first 
requisite  in  those,  who  engage  in  this  holy  call- 

•  .A/,  .AA,  .A/.  .iL. 

in2"        tp       ^       "T?       TV- 


Note  E.— Page  63. 

The  quotation,  to  which  this  note  is  append- 
ed, was  from  an  obituary  notice  published  in  the 
Boston  Daily  Advertiser  and  Patriot,  of  March 
29th,  1835.  It  was  understood  to  be  written  by 
a  class-mate  of  my  son's,  one  of  his  most  inti- 
mate and  dearest  friends,  and  a  man  of  whose 
friendship  any  one  may  be  proud.  My  quota- 
tion from  this  article  was  made  from  memory, 
and  was  not  literally  correct,  but  I  leave  it  as  it 
is.  On  submitting  the  memoir  in  manuscript  to 
the  supervision  of  a  friend,  just  when  it  was 
going  to  the  press,  he  begged  me  to  insert  this 
article  in  a  note.  I  wanted  no  persuasion  to  add 
a  testimonial,  and  an  offering  of  pure  friendship, 
so  grateful  to  my  own  feelings. 

From  the  Daily  Advertiser  and  Patriot. 

Died,  in  this  city,  on  Thursday,  Dr  James 
Jackson,  Jr.,  aged  24. 


100  NOTES 

There  are  circumstances  which  give  this  event 
prominence,  even  among  the  severest  afflictions 
with  which  it  is  the  plan  of  God's  Providence  to 
try  us  in  the  world.  A  few  months  ago,  Dr 
Jackson  returned  from  Europe,  where  he  had 
been  engaged  more  than  two  years  in  the  dili- 
gent study  of  his  profession.  The  praise  of  his 
uncommon  attainments  and  his  ardent  devotion 
to  medical  science,  had  already  reached  us  from 
across  the  sea.  He  was  welcomed  home  by  the 
wide  circle  of  his  kindred  and  friends  whose 
warmest  expectations  he  satisfied.  There  was 
nothing  in  him  which  they  wished  to  alter ;  and 
they  had  everything  to  anticipate  from  his  suc- 
cess in  that  benevolent  province  of  duty,  to  which 
from  childhood  he  had  wished  to  dedicate  his 
life,  and  to  which  he  now  brought  with  him  such 
rich  accomplishments  and  resources. 

He  had  scarcely  ceased  receiving  congratula- 
tions on  his  return  to  his  native  land,  or  had  time 
to  take  the  steps  preparatory  to  commencing 
practice  as  a  physician,  before  he  was  called  off 
from  his  pursuits,  and  laid  prostrate  by  disease. 
The  hearts  of  those,  in  whom  he  had  excited 
just  pride  and  eager  hope,  were  now  agitated 
with  all  the  alternations  of  feeling,  with  which 
we  wait  the  issue  of  a  mali<rnant  and  insidious 


TO    THE    MEMOIR.  101 

disorder.  At  length  they  were  relieved  from 
the  load  of  fear,  by  his  apparently  complete  res- 
toration to  health.  He  came  back  to  us  as  one 
recalled  from  the  gates  of  the  grave,  and  we  felt 
grateful  that  our  prayers  in  his  behalf  had  been 
answered.  We  little  thought  for  how  short  a 
space  he  was  spared  to  us  ;  how  soon  the  treas- 
ure, we  had  taken  anew  into  our  keeping,  was  to 
be  required  at  our  hands. 

He  applied  himself  after  his  recovery,  with 
unabated  earnestness,  to  the  science  and  art  to 
which  his  whole  soul  was  wedded  ;  and  it  did 
not  fail  to  strike  some  of  us,  who  visited  him 
during  his  convalescence,  with  astonishment,  to 
see  how  quickly  and  tenaciously  his  mind  resum- 
ed its  grasp  of  its  darling  subject.  The  degree 
of  Doctor  of  Medicine  was  conferred  on  him  in 
the  month  of  February,  and  it  was  but  a  day  or 
two  after  he  had  publicly  entered  on  the  practice 
of  his  profession,  that  he  was  seized  with  the 
disorder  which  proved  rapidly  fatal  to  him. 

In  the  death  of  this  young  man,  a  thousand 
expectations  are  shattered.  We  have  no  right 
to  use  the  language  of  private  and  exclusive  sor- 
row. He  belonged  to  the  public,  to  whom  he 
had  already  given  pledges  of  rare  eminence  in 
his  profession  ;  and  to  the  troops  of  friends  whom 


102  NOTES 

he  had  bound  to  him  by  the  charm  of  his  pure 
and  enthusiastic  character.  Indeed,  he  was  so 
well  known  to  this  community,  where  he  had  a 
sort  of  hereditary  claim  to  men's  affections,  that 
we  feel  restrained  from  any  attempt  to  draw  the 
character  of  our  friend.  He  does  not  need  our 
inadequate  eulo^.  Short  as  was  his  life,  it  has 
left  imprinted  on  our  memories,  with  perfect  dis- 
tinctness, the  beautiful  traits  of  mind  and  tem- 
per, which  made  him  the  favorite  of  all  who  saw 
him.  To  his  near  and  intimate  acquaintance, 
his  death  seems  like  withdrawing  part  of  the 
general  light  -which  fell  on  their  daily  walk. 
For,  not  only  was  he  one  among  those  whom 
they  chiefly  loved  and  trusted  ;  the  ornament  of 
their  social  circle  ;  one  whose  idea  never  came  to 
them,  but  they  felt  more  respect  for  themselves 
that  they  enjoyed  his  confidence  ;  — but  he  had 
in  him  so  large  a  soul ;  a  spirit  of  such  morning 
freshness  ;  an  interest  so  unexhausted  in  whatso- 
ever was  good  and  true,  in  manners,  opinions, 
persons,  that,  in  losing  him,  our  whole  connexion 
with  society,  our  whole  delight  in  living,  seems 
to  be  loosened  and  impaired. 

We  hardly  dare  intrude,  even  in  our  thoughts, 
on  the  sacredness  of  the  bereaved  home.     What 


TO    THE    MEMOIR.  103 

sorrow  is  like  their  sorrow,  who  mourn  the  sep- 
aration from  such  a  son,  and  such  a  brother  ? 

"Where  is  Timarchus  gone  1 
His  father's  arms  were  round  him, 
And  when  he  breathed  his  life  away. 
The  joy  of  Youth  had  crowned  him. 

Old  man,  thou  wilt  not  forget 

Thy  lost  one,  when  thine  eye 

Gazes  on  the  glowing  cheek 

Of  Hope  and  Piety. 


o 
J) 


Thus  early  has  the  shadow  of  the  dark  valley 
settled  down  over  the  human  prospects  of  him, 
who  seemed  to  be  the  child  of  a  prosperous  for- 
tune. Thus  hastily  has  he  gone  away  to  con- 
verse with  what  is  spiritual  and  eternal.  It  is 
well  with  ki??i.  But  ive  who  had  promised  our- 
selves many  years  to  rejoice  in  his  friendship, 
and  to  witness  the  harvest  of  true  honor  he 
should  reap  in  the  large  field  of  his  usefulness, 
zve,  who  stand  sadly  looking  into  his  sepulchre, 
what  is  to  console  and  cheer  us  ?  God  forbid 
we  should  distrust  His  infinite  love  !  No  :  we 
lay  in  the  earth  the  dust  of  otit  friend,  full  of 
gratitude  for  all  that  he  was  in  himself,  and  for 
all  the  happiness  and  virtue  to  which  he  minis- 
tered, like  a  good  angel,  in  others.  He  has  gone 
while  the   dew  of  his  youth  was  on  him  ;  we 


104  NOTES. 

shall  no  more  see  his  face,  nor  hear  the  sincere 
elo(iuence  of  his  voice.  But  the  beauty  of  his 
life,  and  the  sweetness  of  his  memory  are  ours. 
And  ours  too  is  the  faith  in  the  immortality  of 
the  soul ;  the  assurance  that  the  parting  is  not 
forever ;  that  we  shall  again  greet  our  brother 
in  the  blessed  employments  and  inseparable 
union  of  Heaven  ! 


EXTRACTS 


FROM 


LETTERS  FROM  JAMES  JACKSON,  Je> 


TO     HIS     FATHER 


EXTRACTS  FROM  LETTERS, 


It  will  readily  be  understood  that  in  letters 
WTitten  in  such  entire  confidence,  as  the  follow- 
ing manifestly  were,  there  must  have  been  many 
things  improper  for  the  public  eye,  and  many  of 
temporary  and  personal  interest  only.  Hence, 
there  is  scarcely  one  entire  letter  in  the  following 
collection  ;  and  hence,  I  have  omitted  to  print 
many,  which  might  be  interesting  to  some  minds. 
Wherever  individuals  are  mentioned,  unless 
such  as  may  be  called  public  men,  I  have  sup- 
pressed the  passages  ;  and,  from  the  connexion, 
the  whole  letters  have  in  some  instances  been 
suppressed.  This  has  not  been  because  such 
individuals  have  not  been  mentioned  favorably  ; 
on  the  contrary,  in  most  cases  I  remarked  that  my 
son  avoided  speaking  of  those,  whom  he  could 
not  praise,  unless  from  peculiar  and  rare  circum- 
stances. 


108 


EXTRACTS 


It  may  be  thought  more  necessary,  perhaps, 
for  me  to  apologise  for  printing  so  many,  than 
for  not  printing  more  of  these  letters.  I  can 
only  say  that  I  have  admitted  none,  which  I 
did  not  believe  would  interest  some  of  my  son's 
friends.  It  cannot  be  supposed  that  each  one  of 
them  will  be  interested  in  all  the  letters. 

The  ardor,  the  impetuosity  and  the  freshness 
of  youth,  will  be  sufficiently  obvious  to  the  cool 
and  dispassionate,  in  these  letters.  They  were 
written  by  a  young  man,  principally  in  his 
twenty-second  and  twenty-third  year.  It  will  not, 
I  think,  be  by  persons  of  experience  and  reflec- 
tion, that  these  qualities  will  be  regarded  with 
the  least  charity ;  or,  if  by  any  such,  they  will 
be  those  who  are  not  fathers.  If  I  am  wrong  on 
this  point,  I  fear  not  but  that  I  shall  be  readily 
excused. 

I  wish  to  add  that  these  letters  are  published 
as  they  were  written,  obviously  not  for  the  press, 
with  the  exception  of  the  few  verbal  corrections, 
which  such  compositions  must  always  require. 
I  have  avoided  these  even,  when  not  absolutely 
necessary. 


FROM    LETTERS.  109 

Paris,  October  28,  1831. 
MY    DEAR    FATHER, 

I  feel  almost  disposed  to  cover  a  sheet  or  two 
in  enumerating  the  difficulties  of  auscultation. 
If  Laennec  has  added  an  important  aid  to  our 
insufficient  means  of  exploring  diseases  of  the 
chest,  he  has,  at  the  same  time,  rendered  the 
study  of  those  diseases  more  difficult,  more  labo- 
rious I  would  say,  to  the  learner.  Perhaps  we 
may  better  say,  in  other  words,  that  this  great 
observer  has  so  far  extended  our  knowledge  upon 
this  subject,  by  his  accurate  distinctions,  that  the 
labor,  requisite  to  obtain  all  that  is  known,  is 
much  greater  than  it  has  hitherto  been.  I  have 
just  returned  from  the  Hopital  des  Enfaiis.  where 
I  have  been  experiencing  the  difficulties  and  the 
uncertainties  of  auscultation.  I  have  been  em- 
ployed for  nearly  an  hour  in  examining  two  chil- 
dren, in  both  of  w^hom  there  is  some  reason  to 
suspect  the  existence  of  tubercles.  In  both,  the 
chest  resounds  w^ell  on  percussion  on  each  side  ; 
in  both,  there  is  one  side  where  the  respiration  is 
natural,  strong,  vesicular  ;  in  both,  upon  the  other 
side,  is  an  absence,  or  at  least  a  great  deficiency 
of  the  vesicular  respiration ;  while,  together 
with  a  mucous  and  perhaps  a  crepitous  rale  in 
some  points,  there  is  also  what  seemed  to   me 


110  EXTRACTS 

and  my  friend,  the  interne,  the  bronchial  respi- 
ration. But  if  this  last  supposition  be  true,  the 
diseased  lung  must  be  in  each  case,  in  a  great 
measure,  either  hepatized  or  very  full  of  tuber- 
cles. If  this  were  the  case,  we  should  certainly 
expect  to  find  a  great  difierence  in  the  sound  of 
the  two  sides  by  percussion,  whereas,  the  differ- 
ence, if  there  be  any,  is  very  slight.  I  have 
not  mentioned  all  the  circumstances  of  these 
cases  ;  I  shall  keep  notes  of  them  after  future 
examinations,  and  should  I  ever  know  their  end, 
you  shall  hear  of  it.  You  see  there  is  no  doubt 
which  is  the  diseased  side  in  either  case  ;  the 
difficulty  is  to  pronounce  upon  the  exact  seat  and 
nature  of  the  disease.  By  the  by,  one  of  the 
cases  is  complicated  with  the  contraction  of  the 
side  to  a  very  considerable  degree,  though  the 
child  dates  his  disease  to  six  weeks  only,  has 
not  had  the  ordinary  symptoms  of  pleurisy,  and 
says  he  has  been  well  from  his  infancy.  This 
last,  I  should  doubt.  I  have  mentioned  these 
cases  in  order  to  introduce  the  subject  of  bron- 
chial respiration.  I  was  not  at  all  aware,  or 
rather  I  was  not  fully  aware,  of  the  very  im- 
portant distinction  between  this  and  vesicular 
respiration,  before  I  left  home.  I  knew  the  dis 
tinction  from  description ;  I  had  once   or  twice 


FROM   LETTERS.  Ill 

recognised  it ;  I  knew  generally  what  was 
indicated  by  it ;  but  I  was  not  by  any  means 
aware  in  how  many  cases  it  was  to  be  heard, 
and  under  what  circumstances  it  was  to  be  sought. 
It  has  been  pointed  out  to  me  here  much  oftener 
than  I  expected.  First,  I  heard  it  last  summer 
in  several  cases  in  Andral's  ward,  during  the 
second  stage  of  pneumonia  ;  and  from  him  I 
learned  to  distinguish  it  from  vesicular  respira- 
tion. I  remember  well  one  case,  in  which  he 
said  you  will  hear  upon  the  right  side  the  bron- 
chial respiration  at  the  same  time  with  the  vesic- 
ular, and  on  the  other  the  bronchial  alone.  I 
listened,  and  could  make  this  distinction ;  was 
confident  of  it.  The  difference  consisted  in  a 
slow  expansion  of  the  vesicles  by  the  air  in  the 
one,  and  an  absence  of  this  in  the  other.  From 
that  moment  I  thought  myself  master  of  it. 
Unhappily,  I  was  deceived  ;  and  I  have  often 
had  melancholy  occasion  to  find  that  my  know- 
ledge is  not  yet  perfect  on  this  point.  I  have 
since  had  frequent  occasion  to  hear  this  bronchial 
respiration,  and  to  distinguish  it  with  great  con- 
fidence from  the  vesicular.  At  this  moment 
there  are  two  patients  in  Louis's  ward  at  la  Pi  tie, 
where  I  feel  confident  of  making  the  full  distinc- 
tion.    There  is  also  a  child  at  the  Hopital   des 


112  EXTRACTS 

Enfans,  in  whom  the  difference  between  the  two, 
in  the  whole  extent  of  each  chest,  is  most  decid- 
ed.    Another  has  just  left,  in  whom  I  thought 
the  distinction  also  sure  ;  but,  unhappily,  besides 
these  there  are  other  cases,  like  the  two  which  I 
have  related,  which  are  very  doubtful.     Next  to 
the  bed  in  which  is  placed  the  child,  where  the 
distinction  is  so  marked,  lies  another,  in  whom 
I  feel  almost  sure  of  a  bronchial  respiration  on 
one  side,  and  yet   I  am   distrustful   of  myself. 
Let  me  remark,  en  passant,  one   important  point 
of  difference  between  the  two  cases ;  the  first  is 
chronic,  breathes  slowly  in  comparison,  although 
the  whole  right  lung  is  hors   de   combat  ;  while 
the  other  is   acute,  its   respiration  is   immensely 
rapid,  seventy  while   awake  and  ninety  while 
asleep.     This  rapid  respiration  greatly  increases 
the  difficulty  of  auscultation,  especially   on    this 
one   point,  with  children;    because,  where   the 
respiration  is  thus  rapid,  the  air  hardly  reaches 
the  vesicles,  or  rather  their  expansion  is  so  mo- 
mentaneous,  as  hardly  to  be  distinguishable  from 
the  sound  of  the  air  passing  through  the  bronchia ; 
so  that  the  respiration  in  the  healthy  lung  comes 
greatly  to   resemble  that  in  the   hepatized.     I 
speak  on  this  subject,  because  it  is  one  w^liich  has 
interested  me  much.     Andral  in  his  lecture-room 


FROM    LETTERS.  113 

and  by  his  book,  has  turned  my  attention  very 
strongly  to  it.  As  I  tell  you,  I  have  occasionally 
found  very  great  satisfaction  from  it ;  at  other 
times,  I  have  been  almost  in  despair ;  but  I  say 
to  myself  daily,  "  listen  for  that  slow,  full  expan- 
sion of  the  vesicles,  which  ought  to  exist  in  a 
sound  lung,  and  strive  to  distinguish  it  from  the 
mere  passage  of  the  air  into  the  bronchia."  I 
am  convinced  that  this  is  one  of  the  most  impor- 
tant distinctions  that  can  be  made  by  the  stetho- 
scope. 

The  knowledge  to  be  gained  by  the  ausculta- 
tion of  infants  is  much  greater  than  I  had  sup- 
posed. There  are  certain  points  of  great  difficulty 
like  that  I  have  mentioned  ;  but  as  to  others,  on 
the  contrary,  there  is  a  great  facility.  The  cre- 
pitous  rale  I  think,  is  more  easily  distinguishable 
in  them,  than  in  adults  ;  they  are  examined  with 
greater  ease  and  more  profit  upon  the  dorsal 
region;  and  the  immediate  is  much  more  easily 
practised,  than  the  mediate  auscultation  with 
them.  For  my  part,  I  can  never  henceforth 
examine  a  child  under  disease  without  bringing 
to  my  aid  this  means.  By  the  by,  you  would 
be  much  surprised,  my  dear  father,  to  see  how 
much  more  the  immediate  auscultation  is  used 
here,  than  the  mediate.  There  is  one  other 
8 


114  EXTRACTS 

point,  we  are  too  apt  to  neglect  at  the  Massachu- 
setts General  Hospital ;  it  is  the  examination  of 
the  dorsal  region.  The  French  examine  the 
back  more  than  the  front ;  we  do  the  contrary ; 
both  err,  but  they  the  least. 


Paris,  November  28,  1831. 
I  am  still  following  at  la  Pitie.  I  have  made 
two  or  three  efforts  to  follow  Chomel  at  Hotel 
Dieu ;  —  but  it  is  impossible  to  do  so  with  advan- 
tage. One  may  hear  the  clinique  to  be  sure, 
and  a  very  good  one  too  ;  but  he  cannot  see  the 
patients.  This,  especially  in  my  present  situa- 
tion, is  the  most  important  by  far.  My  great 
object  is  to  accustom  my  ears  to  stethoscopic 
sounds  ;  in  order  to  this  I  must  see  the  patients. 
The  visit  at  Hotel  Dieu  is  commenced  an  hour 
and  a  half  before  clear  daylight,  by  candle-light, 
indeed  ;  —  there  are  from  two  to  three  hundred 
pupils  in  the  wards  at  the  same  time,  and  one  is 
fortunate  if  he  sees  four  patients,  and  examines 
one  in  the  course  of  the  visit.  Whereas,  the 
visit  is  made  at  la  Pitie  by  daylight ;  there  are 
not  more  than  fifteen  students,  and  I  call  it  a, 


FR03I    LETTEKS.  115 

black  day,  in  which  I  have  not  examined  as  many 
as  six  patients  at  least,  who  present  stethoscopic 
phenomena  :  —  ordinarily  I  examine  as  many  as 
ten.  Besides,  as  I  have  told  you  before,  Louis 
gives  a  little  clinique  at  each  bed.  You  see  that 
I  do  right  in  giving  the  preference  to  la  Pitie. 
I  think  I  am  becoming  daily  more  able  to  distin- 
guish the  signs  which  indicate  commencing 
phthisis.     They  are  not  one  but  many. 


Paris,  December  1,  1831. 
^  '^  ^  Are  not  these  cases  replete  with 
interest  ?  "Will  you  not  forgive  your  pupil  for 
darins"  to  write  his  master  such  a  letter  ?  It  is 
only  from  the  fulness  of  the  heart,  that  the 
mouth  speaketh.  But  good  by,  my  dear  father, 
for  the  present.  I  am  daily,  hourly  expecting 
to  hear  from  you  ;  it  is  fifteen  or  sixteen  days 
since  I  have  had  any  letters.  I  hope  for  a  clin- 
ique ;  —  but  as  far  as  I  see,  you  get  more  clin- 
iques  than  I,  from  our  correspondence.  Unfor- 
tunately such  is  the  fashion  of  the  present  day. 
Our  talkers  and  writers  are  those  who  want  expe- 
rience, the  unlearned;  w^hereas,  those  who  are 
able  to  speak  wisely,  are  silent. 


116  EXTRACTS 

Paris,  December  14, 1S21. 

I  have  been  lately  much  interested  in  diseases 
of  the  brain.  Cruveilhier  excited  me  upon  the 
subject.  I  have  since  read  an  excellent  work  by 
Rostan,  on  the  ramollissement  of  the  brain ; 
and  am  now  reading,  with  very  great  pleasure, 
a  most  learned  and  talented  work  by  Lallemand 
of  MontpeUier,  upon  diseases  of  the  same  organ. 
This  last  is  truly  a  master-work.  The  author 
differs  from  Rostan  as  to  ramollissement.  I  have 
read  the  arguments  of  both  and  am  inclined  to 
agree  with  Rostan.  I  find  that  Andral,  in  his 
Anatomical  Pathology,  does  the  same.  There 
is  still  another  standard  author  upon  diseases  of 
the  brain,  —  Bouillaud,  whom  I  intend  to  read 
next.  That,  with  Andral's  promised  volume 
upon  the  brain,  which  will  probably  appear 
shortly,  and  which  I  look  for  impatiently,  will 
give  me  a  pretty  good  knowledge  of  what  the 
French  have  learned  upon  the  subject.  But, 
happily,  I  am  not  left  solely  to  books.  We  have 
now  some  very  interesting  cases  of  cerebral  dis- 
ease in  Louis's  wards ;  —  one  has  particularly 
engaged  my  attention  within  a  day  or  two. 

A  young  man,  headache  for  some  days ;  con- 
siderable febrile  excitement ;  eyes  quite  sensible 


FR03I    LETTERS.  115 

to  light,  and  ears  to  sound  ;  face  flushed,  coun- 
tenance very  serious,  almost  melancholy ;  — 
intelligence  perfect,  but  answers  short,  as  though 
disturbed  by  the  effort  to  speak  ;  no  trouble  in 
chest,  none,  or  but  very  slight,  in  alimentary 
canal ;  —  no  local  symptoms  then,  but  those  of 
cerebral  affection,  and  those  slight;  —  still,  hot 
skin  and  excited  pulse,  which  must  be  accounted 
Tor.  On  the  whole,  the  probabilities  were  in 
favor  of  an  inflammation  of  the  brain,  or  mem- 
branes. He  was  twice  bled  and  is  much  better  ; 
but  the  sensibility  to  light  still  continues.  This 
does  not  seem  to  be  an  extraordinary  case  upon 
paper,  —  and  yet  to  a  mere  hospital  observer,  it 
is  so  ;  —  because  it  shows  him  the  disease  in  its 
very  forming  stage.,  which  is  in  every  disease  by 
far  the  most  interesting,  the  most  important,  and 
the  most  worthy  of  close  attention  and  study. 
It  is  from  this  circumstance  that  I  have  been 
much  interested  in  it. 

Is  it  not  deplorable,  my  dear  father,  that  our 
science  is  yet  so  impotent,  as  to  the  means  it 
affords  us  to  discover  the  first  morbid  changes, 
be  they  of  function,  or  structure  ;  which  last  is 
indeed  but  a  continued  change  of  function,  or 
rather  a  result  of  that  change  ?  Is  it  not  deplo- 
rable that  we  are  obliged   to  rest  satisfied  with 


lis  EXTRACTS 

the  discovery  of  the  existence  of  an  aneurism, 
or  a  schirrous  pylorus,  or  of  tubercles  in  the 
lungs,  or  some  tumor  in  the  brain,  only  at  a  time 
when  they  are  so  far  advanced  as  to  be  beyond 
our  aid  ?  Have  not  the  public  a  right  to  demand 
something  more  of  us  than  this  ?  But  there  are 
limits  set  to  the  advancement  of  our  knowledge 
by  nature  herself.  She  will  not  always  indicate 
by  appreciable  signs  her  commencing  disordered 
actions.  Have  we  yet  reached  these  limits ; 
and  is  there  not  a  portion  of  cases,  in  which  ap- 
preciable signs  do  really  exist,  did  we  but  know 
how  to  seize  them  ?  Has  not  this  subject  been 
too  much  neglected,  my  dear  father  ?  Have  we 
not  too  many  books  devoted  to  the  nice  diagnosis 
of  advanced  disease,  inevitably  fatal ;  and  too 
few  upon  that  of  commencing  disease,  which 
may  be  stopped  in  its  progress  ?  It  is  the  most 
difficult,  and  yet  surely  the  most  important  of 
all  the  subjects,  to  which  the  medical  observer 
can  turn  his  attention.  I  do  not  forget  that  the 
diagnosis  of  an  advanced  disease,  a  cancerous 
pylorus,  for  example,  is  useful ;  that  we  are  bet- 
ter able  to  give  proper  advice  to  our  patient,  than 
if  we  did  not  know  that  such  a  disease  existed  ; 
—  but,  surely,  it  would  be  far  better  if  we  could 
be  apprised  of  the  first   disorder   of  the   vessels 


FROM   LETTERS.  119 

engaged  in  this  morbid  process.  I  know  well 
we  can  never  become  perfect  in  this  respect ;  — 
yet  I  cannot  but  hope  that  the  time  will  come, 
when  we  shall  be  far  in  advance  of  our  present 
knowledge.  At  present,  the  discovery  of  even 
far-advanced  disease,  which  is  soon  to  destroy 
life,  is  often  beyond  our  power. 

My  mind  has  been  turned  to  this  subject  for  a 
day  or  two  from  reflecting  upon  two  cases,  now 
in  our  wards ;  —  one,  that  I  have  just  related,  of 
commencing  cephalitis  discovered  at  its  debut,  in 
which  life  was  saved  by  active  treatment ;  and 
a  second,  of  aneurism  of  the  thoracic  aorta,  which 
is  but  lately  discovered  and  will  shortly  prove 
fatal ;  • —  an  exceedingly  interesting  case. 


Pabis,  February  16,  1832. 
"  Laennec  has  rendered  a  gTeat  service  to  sci- 
ence by  his  description  of  emphysema  of  the 
lungs,"  said  Louis,  yesterday  evening ;  and  I 
may  add,  Louis  has  rendered  me  a  great,  a  very 
great  service,  by  teaching  me  the  characters  of 
this  disease,  during  life  and  after.  His  two  last 
lessons  upon  this  subject  were  invaluable.     I  did 


120  EXTRACTS 

not  know  the  disease  when  I  left  you,  except  in 
the  pages  of  Laennec.  I  now  know  that  it  is 
common,  and  that  a  knowledge  of  it  is  very  im- 
portant. Shall  I  give  you  the  proof  that  it  is 
common  ?  I  have  seen  at  least  ten  cases  within 
six  we^s  ;  and  I  speak  of  those  only,  which  I 
have  myself  examined  either  before  or  after  death. 
Shall  I  prove  to  you  that  an  acquaintance  with 
this  disease  is  practically  useful  ?  I  can  do  it 
in  more  ways  than  one ;  but  I  choose  to  illustrate 
its  utility  by  telling  you  of  a  false  diagnosis  of 
my  own. 

Yesterday  morning  I  examined  by  ausculta- 
tion a  young  man,  with  whose  history  I  was  not 
acquainted,  without  having  first  practised  percus- 
sion in  a  careful  manner.  He  is  emaciated  and 
coughs  ;  this  was  all  I  knew  of  him,  and,  in 
truth,  my  examination  was  made  very  much  €7i 
passant.  I  found  the  respiration  much  more 
feeble  under  the  left  clavicle  than  the  right,  and 
suspected  at  once  the  existence  of  tubercles. 
Having  requested  one  of  my  friends  to  examine 
him,  he  came  to  the  same  result,  and  in  the  even- 
ing we  mentioned  to  Louis  our  suspicions  that 
the  subject  was  tuberculous.  He  said  he  did  not 
believe  it.  On  careful  examination  we  found 
that  the  percussion  was  more  sonorous   under 


FROM    LETTERS.  121 

the  left  clavicle  than  the  right,  but  at  the  same 
time  the  murmur  of  respiration  was  much  fee- 
bler under  this  left  clavicle,  as  it  was  indeed  over 
the  whole  extent  in  front,  where  the  sound  on 
percussion  was  still  quite    sonorous.     We  now 
saw  our  mistake  and  immediately  recognised  an 
emphysema.     On  inquiring  into  the    history  of 
the  case,  we  found  that  it  accorded  with  this  last 
supposition,  but  not  with  that  of  a   tuberculous 
affection.     Here  would  have  been  a  very  grave 
error  in  the  diagnosis,  on  my  part ;  and  the  les- 
son was  a  very  useful  one.     I  cannot  doubt  that 
many  a  case  of  emphysema  has    and   will   be 
mistaken  for  phthisis  by  those,  who  are  but  par- 
tially acquainted  with   the  science   of  ausculta- 
tion ;  —  unless  they  are  so  well  acquainted  with 
the  natural  history  of  phthisis,  so  as  to  be  able 
in  a  great  measure  to  supply  thereby  their  defi- 
ciencies in  the  "  musical  science."     I  asked  Louis 
whether  he  had  often  seen  emphysema  mistaken 
for  phthisis  ;  —  he  answered,  very  frequently. 

^  #  ^  But  I  have  almost  forgotten  to  tell 
you  of  a  case,  which  shows  me  of  what  use 
auscultation  and  percussion  are  to  be  to  me  in 
practice. 

I  observed,  a  few  days  since,  that  one  of  my 
young  friends  here  looked  rather  unwell,  rather 


122  EXTRACTS 

more  so  in  fact  than  is  common  from  a  sli2:ht 
catarrh,  which  was  all  he  complained  of.  I  told 
him,  I  should  come  and  see  him  at  night,  and 
went  accordingly.  We  laughed  and  talked  for 
some  time,  he  appearing  pretty  well.  On  my 
questioning  him,  I  found  he  had  a  little  pain  on 
the  right  side  on  coughing  and  on  full  inspira- 
tion. He  thought  nothing  of  it,  however,  and 
said  he  had  nothing  but  a  slight  bronchitis.  I 
examined  his  chest  not  expecting  to  find  anything, 
so  slight  were  the  local  and  general  symptoms. 
On  the  right  back,  however,  I  found  evidence, 
by  percussion  and  auscultation,  of  a  considerable 
pleuritic  effusion.  I  bled  him  freely  ;  he  has 
recovered  and  the  fluid  absorbed.  I  mention  the 
case  to  you,  because  it  is  the  first  time  that  I  have 
been  obliged  to  practise  upon  the  evidence  of 
auscultation,  in  an  acute  case  ;  and  because  cases 
of  this  sort  cannot  be  too  often  cited,  so  frequent, 
so  latent  and  so  important  are  they.  How  many 
thousands  of  pleurisies  pass  unnoticed.  Not  so 
in  Louis's  wards,  however ;  and  thanks  to  him, 
not  so  many  will  escape  me,  as  would  have,  with- 
out his  example  and  instructions.  In  the  present 
case,  perhaps,  indeed,  almost  certainly,  this  young 
man  would  have  recovered  without  any  treat- 
ment.    But,  if  the  disease  had  not  been  discov- 


FROM  LETTERS.  123 

ered,  it  would  probably  have  been  aggravated,  as 
he  would  have  contmued  his  dissections  in  a  cold 
room^  and  in  other  ways  have  exposed  himself; 
and  the  inflammation  might  then  have  extended 
from  the  serous  to  the  cellular  tissue. 

Feb.  17.  How  unhappily  imperfect  are  our 
histories  of  even  the  most  common  diseases  ! 
How  often  have  exceptional  cases  been  mistaken 
for  ordinary  ones  !  ^Yhat  false  descriptions 
have  authors  given  us  of  pleurisy  and  pericardi- 
tis, for  example  ;  taking  for  the  type  of  those 
diseases  a  few  rare  cases,  which  were  attended 
with  very  positive  and  striking  symptoms,  and 
overlooking  the  vastly  more  common  cases,  in 
which  these  symptoms  are  far  less  marked  and 
sometimes  entirely  absent !  I  have  been  espe- 
cially struck  with  this  in  pericarditis;  —  and 
what  have  been  the  causes  of  this  error  ?  Perhaps 
chiefly  two  ;  —  first,  owing  to  an  insufficient 
examination,  a  large  majority  of  cases  are  over- 
looked during  life.  This  you  know  to  be  liter- 
ally true  in  the  case  of  pleurisy,  and  I  believe  it 
to  be  so  in  pericarditis.  I  often  think  of  your 
recital  of  the  case  of  pericarditis  in  a  certain 
cook,  since  I  have  attended  to  this  subject ;  and 
when  you  have  received  one  of  my  letters  of 
about  a  month  since,  I  do   not  doubt  you   will 


124  EXTRACTS 

remind  me  of  it.  Second,  because  practitioners 
have  not  been  in  the  habit  of  counting  their 
cases,  preferring  to  trust  to  their  memories  and 
what  is  called  general  observation.  Louis  is  the 
father  of  the  numerical  system,  and  will  at  some 
time  publish  to  the  world  the  tables  containing 
the  results  of  his  practice.  There  can  be  none 
more  valuable  for  diseases  of  the  chest,  at  least ; 
for  he  is  the  most  exact  in  his  investigations  and 
diagnosis  of  any  living  man. 

^  ^  ^  «  But,"  says  the  practical  physician, 
"  this  is  all  nonsense  ;  why  trouble  yourself  about 
a  disease,  which  nature  will  cure  without  your 
help,  as  she  will  all,  or  almost  all  those  cases  of 
undiscovered  pleurisy,  and  pericarditis  too  ?" 
The  practical  man  here  forgets  what  should  be 
the  first  principle  of  every  good  practitioner  in 
medicine,  or  morals  ;  —  to  treat  disease  success- 
fully, we  must  attack  it  at  the  commencement ; 
and  many  of  these  cases,  which  begin  with  such 
latent  symptoms,  and  which  are,  in  very  truth,  of 
themselves  comparatively  unimportant,  become 
very  severe  and  fatal  from  a  neglect  of  even  h^^- 
gienic  rules.  A  man  continues  to  expose  himself 
while  affected  with  a  latent  attack  of  pleurisy, 
and  in  a  week  he  may  have  an  extensive  pneu- 
monia which  shall  destroy  him.     But,  again,  the 


FROM   LETTERS.  125 

man  who  enters  into  the  field  of  pathology  with 
his  eyes  open,  and  does  not  love  truth  for  truth's 
sake  in  his  scientific  researches,  may  possibly  be 
a  moral  man,  though  I  should  almost  doubt  it ; 
at  any  rate,  he  will  make  livery  poor  practitioner. 
I  must  indeed  work  for  my  bread,  but,  in  work- 
ing, if  you  take  from  me  the  interest  which 
search  after  pathological  truth  inspires,  I  can  no 
longer  work  well. 


Paris,  February  27,  1832. 
^  ^  ^  The  truth  is  Louis  is   a  remarkable 
man,  and  his  system  of  pursuing  medical  sci- 
ence a  most  excellent  one.     There  are    without 
doubt  many  questions  that  cannot  be  resolved  by 
counting ;  but  to  draw  a  description  of  the  natu- 
ral history  of  diseases,  you  cannot  proceed  with- 
out it.     What  is  the  chance  that  such  a  disease 
will  prove  fatal  ?     How  often  does  such  a  symp- 
tom occur  ?     What  part  of  an  organ  is  most  often 
affected  in  a  certain  disease  ?     How  often  is  such 
and  such  a  lesion  found  after  death,  when   such 
and  such  symptoms  have  preceded  ?     These  are 
all  questions  of  immense  importance,  and  they 


126  EXTRACTS 

can  be  decided  in  no  other  way  than  by  an  accu- 
rate observation  of  all  the  cases  which  occur,  and 
a  counting  of  them  with  respect  to  each  point. 
You  state  that  pneumonia  occurs  oftener  on  the 
right  than  on  the  left,  that  it  affects  the  lower 
oftener  than  the  upper  lobes  ;  suppose  some  one 
chooses  to  doubt  it,  and  demands  of  you  what  is 
the  proportion,  in  order  that  he  may  know  wheth- 
er your  knowledge  be  exact.  You  have  made 
no  table ;  you  can  only  tell  him  such  is  your 
general  experience.  General  experience  has  for 
this  once  told  you  the  truth ;  but  it  would  be 
much  more  satisfactory  for  your  student,  if  you 
could  give  him  the  result  in  numbers  deduced 
from  exact  observation.  And,  in  fact,  what  is 
this  general  experience ;  it  is  the  result  of  an 
enumeration  of  the  cases,  seen  by  an  individual, 
in  his  own  memory.  But  how  much  better 
would  this  enumeration  have  been  made  on 
paper  ;  for  who  can  tell  that  from  some  peculiar 
circumstance  or  association,  one  class  of  cases 
may  not  have  excited  his  attention,  and,  there- 
fore, left  a  more  permanent  impression  than 
another  ;  —  so  that  a  greater  number  of  these 
first  would  enter  into  the  calculations  of  the  mem- 
ory than  of  the  last.  Had  medicine  been  studied 
for  one  hundred  years,  as  Louis  now  studies  it, 


FROM   LETTERS.  127 

our  knowledge  of  the  natural  history  of  disease 
would  be  placed  upon  an  infinitely  more  certain 
basis  ;  and  diagnosis,  and  prognosis,  and  conse- 
quently therapeutics  vastly  more  advanced.  On 
my  return  I  will  prove  to  you  the  adv^antages  of 
this  system.  Inspired  with  this  belief,  viz.  that 
the  only  way  to  place  our  knowledge  of  disease 
upon  a  true  basis,  is  to  make  rigorous  observa- 
tions, and  to  count  them  under  their  various  bear- 
ings and  relations,  —  a  set  of  young  men,  who 
have  for  a  long  time  followed  Louis,  (and  some 
of  whom  I  know,  or  believe  to  be  the  most  intel- 
ligent of  the  French  students,  my  colaborators, 
of  whom  I  wrote  yesterday,)  intend  forming  a 
society,  whose  main  purpose  is  to  make  exact 
observations  over  the  whole  world,  as  far  as  may 
be  :  and  from  these,  properly  arranged  and  sub- 
mitted to  the  numerical  method,  to  arrive  in  the 
course  of  years  at  certain  and  fixed  laws.  Those 
who  have  followed  Louis,  the  father  of  this  meth- 
od, are  alone  to  become  members ;  and  of  those 
I  trust  only  a  select  corps  ;  for  the  majority  are 
not  fit  to  make  accurate  pathological  investiga- 
tions. As  yet,  I  am  the  only  American  who 
knows  of  their  plans,  and  I  certainly  shall  with 
great  pleasure  become  a  member,  promising  in 
all  honesty  to  elicit  from  our  public  institutions 


128 


EXTRACTS 


whatever  is  in  my  power.  I  shall  love  to  work 
for  such  a  society,  because  it  will  be  useful  not 
only  to  myself,  but  to  all :  and  again,  by  so  doing 
I  shall  keep  up  an  acquaintance  with  these  Eu- 
ropeans who  will  be  the  most  distinguished  in 
medicine  during  my  day.  Say  nothing  of  this 
as  yet,  for  it  is  not  made  public,  —  I  shall  write 
you  as  soon  as  the  society  is  organized  and  ex- 
plain in  full  its  objects,  &c.  It  is  to  me  a  new 
spur  to  study ;  —  for  I  am  now  learning  how  to 
observe. 


Paris,  March  1,  1832. 
^  #  ^  You  write  so  warmly  of  Hodgkin's 
museum  and  Hunter's,  as  to  excite  in  me  a  strong 
desire  to  enjoy  these  promised  pleasures.  But 
I  shall  not  hurry  while  Louis  calls  me  to  listen 
to  his  interesting  clinique,  in  which  he  gives  us 
the  thread,  whereby  to  walk  through  the  laby- 
rinth of  pulmonic  disease  ;  and  while  he  deigns 
to  teach  me  in  a  more  familiar  manner  in  his 
wards.  Neither  do  I  feel  inclined  to  tear  myself 
from  the  eloquent  course  of  Andral,  of  which  I 
have  as  yet  taken  most  copious  notes  ;  nor  to  fore- 
go the  delight  of  his  clinique,  which  will  com- 
mence in  May. 


FROM    LETTERS.  129 

Paris,  March  20,  1832. 

#  ^  #  You  see  I  am  getting  to  make  nice 
distinctions  in  auscultation,  perhaps  you  will 
think,  too  much  so.  But  I  assure  you,  you  can- 
not at  ail  judge  of  m.y  knowledge  of  this  subject 
now  by  what  it  was  when  I  left  you.  Louis 
chooses  for  us  the  most  delicate  cases  ;  —  makes 
us  examine  and  report  to  him  the  result,  without 
telling  us  his  opinion,  and  even  without  allowing 
us  to  learn  anything  of  the  history  of  the  case, 
lest  we  should  be  prejudiced.  I  am  exceedingly 
happy  to  add  that  it  very  rarely  happens  that  we 
differ  in  opinion  from  this  master  of  his  science. 

I  feel  confident  that  our  "  Society  of  Medical 
Observation"  will  be  a  useful  one,  and  am  sorry 
that  I,  cannot  pass  one  year  in  sharing  its  labors 
under  the  direction  of  Louis.  The  object,  as 
you  know,  is  the  exact  ohsertation  of  diseases, 
and  from  the  cases  afforded,  to  deduce  what  gen- 
eral facts  may  be  rigorousl}?-  deduced. 

The  numerical  method,  luithout  care^  may  lead 
into  error  ;  —  but,  first,  it  must  lead  to  a  vast  deal 
of  good  ;  —  and  second,  as  for  the  care  to  avoid 
those  errors  conse<[uent  on  an  omission  of  a  full 
consideration  of  all  the  circumstances,  if  any 
man  will,  and  does  secure  himself,  it  is  Louis, 
the  father  of  the  system.  His  wards  are  the 
9 


130  EXTRACTS 

only  ones  I  have  ever  seen,  except  your  own, 
where  the  facts  were  all  truly,  fairly  and  scru- 
pulously noted  ;  and  on  one  branch  he  necessaril'g 
surpasses  you,  viz.  morbid  anatomy  ;  for  in  out 
country  it  is  impossible  to  follow  this  subject 
with  such  freedom,  owing  to  the  prejudices  exist- 
ing among  us  ;  and  at  our  hospital  our  cases  are 
necessarily  imperfect,  as  we  do  not  retain  our 
chronic  cases,  as  they  do  here,  till  death. 

#  :^  ^  There  are  two  or  three  young  men 
whom  I  should  be  proud  to  see  in  Boston,  espe- 
cially Maunoir  and  Lacaze.  They  are  young 
men  whom  I  shall  always  remember  with  pleas- 
ure and  respect. 

March  29.  —  Little  did  I  think,  my  dear 
father,  when  I  began  this  letter,  that  I  should  be 
obliged  to  close  it  with  such  umvelcome  news. 
The  cholera  is  in  Paris  ;  —  or,  to  say  the  least, 
it  is  generally  believed  to  be  so  both  by  the  public 
and  by  physicians  ;  and  I  fear  the  evidence  is 
too  strong  to  deny  it.  Of  facts,  I  as  yet  know 
very  little ;  —  I  have  heard  and  read  in  the  jour- 
nals of  several  (from  ten  to  fifteen)  cases  at  Ho- 
tel Dieu  and  in  this  city.  I  have  conversed  with 
those,  who  have  seen  some  of  these  patients  dur- 
ing life,  and  with  others  who  have  been  present 
at  some  of  the  autopsies  of  those,  who  have 
died. 


FROM    LETTERS.  131 

*  #  ^  I  believe  the  case  to  be  cholera,  from 
the  suddenness  of  the  death,  the  history  of  the 
symptoms,  and  the  coincidence  of  several  similar 
cases  in  other  parts  of  the  city.  I  know  well 
that  it  admits  of  question,  but  cannot  here  dis- 
cuss it. 

Shall  I  leave   Paris   because    the  cholera   is 
here  ?     If  I  do,  where  shall   I  go?     These  are 
my  two  important  questions.     And  I  can  answer 
neither  as  yet.     Surely,  in  the  present  state  of 
affairs,  I  should  regard  it  as  very  useless  to  leave 
the  city,  for  I   do  not  feel  that  I  am   in   danger. 
Should  circumstances  change,  I  shall  act  accord- 
ingly.    The  disease  has    left  Edinburgh,    and 
should  it  prevail  here  to  such  a  degree  that  An- 
dral  and  Louis  think  me  exposed  to  real  danger, 
I  will  leave.     In  the  mean  time,  all  the  students 
see  the  disease,  and,  though  I  shall  not  run  much 
after  it,  my  curiosity  is  excited,  and  probably   I 
shall  see  it.     I  am  in  full  health,  have  no   fears, 
will  lead  the  most  simple  and  hygienic  life,  and 
be  assured  I  will  be  prudent.     Were  you  on  the 
spot,  you  would  not  regard  my  situation   as    in 
any  way   dangerous  ;  —  of  this,  I   am   sure.  — 
Should  my  motions,  or  any  other  circumstance 
require  it,  I  shall  write  you  a  duplicate  by   the 
Liverpool  Packet  of  the  8th.     But   I   beg   and 


132  EXTRACTS 

pray  of  you  not  to  allow  yourself  a  moment's 
anxiety.  I  will  be  prudent,  and  there  is  not 
one  chance  in  five  thousand  that  I  shall  suffer  by 
the  disease. 


"-"        Paris,  April  1,  1832. 

MY  DEAR  FATHER, 

I  lament  to  tell  you  that  the  cholera  which  was 
yet  a  little  doubtful  when  I  last  wrote,  (three 
days  since,)  is  now  reigning  in  Paris;  and  I 
must  add  to  a  frightful  degree.  You  will  learn 
details  from  the  journals.  To  this  moment  there 
are  at  least  three  hundred  cases,  and  a  full  half 
already  dead.  But  you  are  anxious  for  me  ;  — 
you  suffer  because  I  still  remain  here  ;  —  perhaps 
you  even  reproach  me  with  an  undue  inattention 
to  the  rights  and  feelings  of  my  family.  A  word 
upon  this  subject.  1st.  What  is  my  actual  dan- 
ger ?  I  do  not  deny  that  the  first  blow  is  very 
strong,  in  truth  frightfuUy  so.  But  who  are  the 
subjects  affected?  Up  to  this  moment  exclu- 
sively the  lower  classes.  I  have  inquired  of 
many  physicians  and  among  them  of  those 
whose  practice    is   extensive; — they   have  not 


FROM    LETTERS.  133 

seen  a  man  in  easy  circumstances  affected  ;  — 
the  journals  say  the  same.  Thus  as  yet  my 
langer  is  very  slight,  though  living  in  the  midst 
nf  disease  ?  But  again,  why  should  I  stay  in 
Paris  ?  In  the  first  place,  the  disease  came  upon 
us  so  suddenly  that  we  had  no  time  to  leave. 
On  Wednesday  I  first  heard  of  its  existence,  and 
.already,  Sunday,  there  are  three  hundred  pa- 
tients. We  could  not  have  left  the  first  day,  for 
we  were  not  yet  assured  ;  and  now  what  are  my 
circumstances  ?  I  am  here  with  perhaps  thirty 
American  students,  and  of  them  all,  I  may  say 
with  truth,  my  mind  has  not  been  the  least  occu- 
pied with  medicine  for  some  years.  We  are  in 
a  city  where  we  may  see  a  disease  of  the  most 
frightful  nature,  —  which  will,  in  all  probability, 
soon  reach  our  own  dear  country.  We  are 
bound  as  men  and  physicians  to  stay  and  see  this 
disease  ;  —  as  a  physician  you  know  it  and  feel 
it ;  —  as  a  father  you  dread  it.  For  myself,  I 
confess  I  should  be  unwilling  to  return  to  Amer- 
ica, and  not  have  at  least  made  an  effort  to  learn 
the  nature  and  the  best  treatment  of  this  destroyer 
of  life.  I  feel  bound  to  remain  with  the  rest ; 
—  for  no  one  thinks,  as  yet,  of  leaving.  As  yet 
the  probability  is  that  it  will  continue  and  even 
increase;  —  but  this    is   not    sure.     Should    it 


134  EXTPACTS 

thus  continue,  I  probably  shall  not  stay  here 
more  than  one  or  two  weeks  ;  I  shall  have  seen 
enough  of  the  disease,  and  if  it  reigns  as  now, 
all  clinical  instruction  will  continue  to  be,  as  it 
actually  is,  interrupted.  Wherefore  then  stay 
longer  ?  But  we  may  hope  that  a  little  calm  will 
soon  follow,  and  that  this  severe  debut  will  be 
followed  by  a  rapid  march  and  prompt  termina- 
tion. If  so,  all  my  instruction  will  be  continued ; 
I  need  not  lose  the  remainder  of  my  lessons 
from  Louis,  &c.  As  it  is,  then,  though  there  is 
some  danger,  it  is  very  slight.  I  shall  therefore 
stay.  Again,  feeling  it  to  be  a  duty,  and  really 
having  my  mind  greatly  interested  and  excited, 
I  do  and  shall  see  the  disease.  But  should  the 
danger  become  truly  great,  I  shall  leave  at  once 
for  Scotland  ;  and  should  the  disease  so  continue 
that,  after  a  fortnight,  I  cannot  recommence  my 
ordinary  studies,  I  shall  likewise  leave  the  city. 
In  the  meantime  I  shall  today  engage  lodgings 
with  my  two  Philadelphia  friends,  on  the  other 
side  of  the  river,  in  the  most  healthy  part  of  Pa- 
ris, where  the  disease  has  not  yet  appeared  ;  —  I 
shall  live  simply,  sleep  and  rise  early,  and  in 
every  way  pursue  the  most  strict  hygienic  rules. 
Thus  much  for  myself,  and  I  hope  you  are  sat- 
isfied.    I  forgot  to  notice  that  I  am  in  perfect 


FROM    LETTERS. 


135 


health,  and  that,  although  my  mind  is  necessarily 
excited,  yet  I  have  neither  fear  nor  anxiety. 

Now,  for  the  disease  ;  —  one  word  ;  —  it  is 
death.  Truly,  at  Hotel  Dieu,  where  I  have  seen 
fifty  and  more  in  a  ward,  it  is  almost  like  walking 
through  an  autopsy  room  ; — in  many  nothing 
but  the  act  of  respiration  shows  that  life  still 
.exists.  It  is  truly  awful.  —  As  for  treatment, 
nothing  is  yet  decided.  I  cannot  find  that  any 
of  the  thousand  different  modes  essayed  is  in 
truth  very  powerful ;  —  and  certainly,  whatever 
be  their  potency,  the  effect  is  almost  null.  The 
physicians  are  in  a  state  of  the  greatest  incerti- 
tude, not  knowing  which  way  to  turn.  I  cannot 
pretend  to  give  you  any  detailed  account  of 
symptoms  or  treatment. 

I  can  only  say  that  the  disease  is  in  truth  al- 
most a  conversion  instantaneously  from  life  to 
death. 

In  my  next,  by  Liverpool  on  the  8th,  you  shall 
receive  something  more  precise.  —  My  head  is 
now,  as  one  may  say,  montee,  and  I  haste  for  the 
estafette. 


136  EXTRACTS 

Paris,  April  8,  1832. 
MY    DEAR    FATHER, 

I  almost  weep  to  write  you  again  from  Ptiris. 
It  is  now  the  first  moment  of  my  life  that  I  have 
been  placed  between  two  duties,  each  strong, 
each  binding,  and  where  my  great  difficulty  is  to 
decide  which  is  the  most  so.  But  I  have  de- 
cided, as  I  know,  against  your  wishes.  God 
grant  that  circumstances  may  be  such  that  you 
shall  soon  accord  with  me,  when  the  time  is  pass- 
ed. A  medical  man  has  duties  ;  —  I  am  a  boy 
in  medicine  ;  —  granted  ;  —  but  I  am  like  the 
other  Americans  here  about  me.  An  opportunity 
is  offered  us  to  study  a  disease,  which  will  prob- 
ably visit  our  hitherto  untouched  countr}?-.  Were 
the  disease  about  you,  would  you  fly  ?  You 
could  not,  for  the  public  would  look  to  you  ;  — 
you  would  not,  for  your  sense  of  duty  would 
prevent  you.  I  am  in  a  measure  in  the  same 
condition.  From  a  week's  accurate,  patient,  la- 
borious study  of  the  disease,  before  and  after 
death,  as  to  its  nature  and  the  effect  of  treatment 
upon  it,  I  am  now  assured  that  there  is  much  to 
be  learned  and  much  that  is  therapeutically  im- 
portant. I  doubt  whether  our  profession  will 
ever  be  able  to  divest  it  of  its  greatest  horrors  : 
—  this  I  do  not  hope  for ;  —  for  I  see  no  ground 


FROM    LETTERS. 


137 


for  such  hope.  But  I  do  believe  that  an  exact 
study  of  the  latter  part  of  this  disease,  after  the 
reaction  is  established,  and  observation  of  the  ef- 
fects of  treatment  upon  it,  may  lead  to  much  that 
is  useful.  Persuaded  of  this  as  I  am,  I  feel  it  a 
duty  thus  to  study.  If  I  can  be  the  means  of 
directing  the  attention  of  our  physicians  to  certain 
-points,  an  attention  to  which  will  enable  them  to 
save  one  in  twenty  of  those  affected,  and  that  one 
would  have  died  without  it,  — what  is  my  duty  ? 
to  stay  and  study.  As  an  individual  I  do  not  hes- 
itate thus  to  answer  ;  —but  when  I  remember 
you,  my  dear  father,  I  tremble  that  I  have  thus 
answered. 

I  am  with  Andral.  During  five  days  we 
have  had  eleven  very  exact  autopsies ;  with 
which,  with  the  whole  history  of  the  cases, 
besides  numerous  others,  some  dead,  some  living, 
now  to  die,  some  in  fact  dying  now  around  m.e, 
(for  I  write  in  the  ward  of  la  Pitie,)  some  I  am 
happy  to  add  in  a  fair  way  to  recovery,  I  will  ac- 
quaint you  hereafter.  But  I  will  write  no  details 
now  ;  —  I  purposely  avoid  them. 

I  will  but  add  two  circumstances  which  shall, 
or  ought  to  serve  to  diminish  your  anxiety.  — 
1st.  As  yet,  aUhough  the  disease  increases  in  a 
truly  awful  manner,  there  are  but  few  cases  in 
the  upper  classes. 


138  EXTRACTS 

2(1.  Of  those  affected  with  the  disease,  there 
are  very  few  of  my  age,  or  near  it.  I  must  have 
seen  five  hundred  patients,  at  least,  and  of  those 
not  ten  under  thirty.  I  cannot  indeed  recall 
five  ;  —  and  not  one  have  I  seen  in  the  dissect- 
ing-room. 

The  only  young  man  under  Andral's  care  now 
lies  in  the  bed  behind  me,  convalescent.  Yet, 
there  is  some  danger  ;  it  is  in  vain  to  deny  it ; 
but  it  is  not  great.  And  I  am  happy  to  add  that, 
since  the  appearance  of  the  cholera,  I  have  been 
in  a  little  more  perfect  health  than  before,  though 
that  had  seemed  impossible.  Most  of  my  friends 
have  had  a  little  diarrhoea,  or  cramps,  &;c. ;  I 
not  any.  Not  one  of  my  acquaintance  has  been 
seriously  sick.  I  live  as  usual,  but  with  exces- 
sive care.  I  work  harder  than  ever  in  my  life 
before.  A  month  hence,  I  will  send  you  the  re- 
sults on  paper  ;  — but  it  will  be  a  year  before  I 
can  show  you  the  full  results  ;  for  I  am  learning 
more  on  the  pathology  of  mucous  membranes 
(intestinal  and  gastric)  than  ever  before.  But  of 
this  by  and  by.  I  have  determined  to  send  you 
no  details  as  yet ;  —  but  I  keep  a  daily  record  for 
you,  which  will  be  long,  and  probably,  unless  the 
disease  becomes  such,  that  I  esteem  myself  in 
essential  danger,  I  shall  send  you    one  hundred 


FROM    LETTERS.  139 

detailed  observations,  (of  which  I  have  already 
thirty,)  and  forty  or  fifty  of  the  most  thorough 
and  accurate  autopsies  that  you  ever  read.  From 
these,  when  collected,  I  propose  to  draw  what 
conclusions  I  can  as  to  the  nature  and  treatment 
of  the  disease,  in  making  a  nice  analysis  and 
synthesis  of  all  the  circumstances.  I  flatter  my- 
■  self  that  I  can  do  this  in  such  a  manner  as  will 
be  truly  useful.  I  shall  do  it  in  England,  taking 
my  papers  with  me,  and  devoting  my  first  one  or 
two  weeks  there  to  this  work.  I  would  prefer 
vastly  to  have  sent  you  one  of  the  half  dozen 
sheets  I  have  written  this  day  ;  but  it  has  been 
my  determination  to  avoid  advancing  an  idea 
till  all  is  done.  Not  a  single  fact  has  yet  occur- 
red to  show  that  the  disease  is  contagious  ;  —  not 
a  physician,  nor  interne,  nor  student  of  the  hos- 
pital has  been  affected.  A  week  or  two,  my  dear 
father,  and  you  will  hear  from  me  in  England. 


Havre,  April  25,  1832. 

On  my  way  to  London,  as  you  see,  my  dear 
father,  and  perhaps  will  wonder  why ;  surely, 
when  I  last  wrote  you,  I  expected  to  stay  in  Paris 


140 


EXTRACTS 


a  fortnight  longer.  I  have  left  because  the 
cholera  has  almost  ceased,  not  because  it  had 
increased  in  severity.  I  have  left  for  want  of 
cases  to  study.  In  very  truth  during  the  last 
three  days,  in  a  service  of  fifty  beds  under  Louis, 
we  had  not  a  single  new  case  of  any  severity  ; 
and  he  advised  me  as  I  was  beginning  to  suffer 
from  fatigue,  (for  never  in  my  life  have  I  worked 
so  laboriously,)  to  leave,  contented  with  the  sixty 
or  seventy  cases  and  more  than  thirty  autopsies. 
In  London,  as  you  know,  the  disease  is  about 
extinct,  (seven  cases  a  day).  In  Paris  it  still 
exists  ;  I  saw  cases  and  deaths  till  the  very  last 
moment,  but  much  fewer  and  much  less  severe. 
You  have  no  conception  of  the  mortality ;  and 
allow  me,  your  son  and  pupil,  to  say  to  my  father 
and  master,  you  have  no  conception  of  the  dis- 
ease, and  will  not  have,  till  you  have  seen  it. 
The  Frenchmen  even,  who  look  upon  death  and 
dying  with  as  much  sang  froid  as  any  people, 
were  thrown  off  their  balance.  Never  shall  I 
forget  Louis's  altered  face  and  aspect  for  the  first 
week; — emaciated,  wan,  wretched,  like  one 
who  had  received  a  blow  from  which  he  had  not 
recovered.  There  are  few  men  living  so  familiar 
with  death,  or  the  dead. 


FROM    LETTERS.  141 

Liverpool,  June  30,  1832. 
MY     DEAR    FATHER,  

I  received  last  night  with  great  pleasure  yours 
of  May  19th — 25th.     The  last  releases  me  from 
all  apprehension  as  to  your  judgment  upon  my 
stay  in  Paris.     I  rejoice  that  you  view  it  as  I  do. 
A  word  on  cholera,  and   then  I   will  dismiss    it. 
Not  a  day  passes,  that  I  do  not  picture  to  myself 
the  possibility  of  its  actual  or  future  existence  on 
our  own  side  of  the  Atlantic.     Of  course  I  keep 
myself   always    ready    to   see  if    there    be    any 
truth  in  the  reports  of  the  new  modes  of  treat- 
ment of  it.     In  London,  as   I  told  you,  I   saw  a 
few  cases  vdth   Dr  Stevens,  but    none   of  them 
were  at  all  satisfactory,  for  various  reasons  which 
you  shall  have  in  detail  in  your  own  study,  or  in 
mine,  by-and-by.     In  passing  through  Yorkshire, 
where  the  disease  is  prevailing,  I  inquired,  when- 
eA^er'I  had  an  opportunity,  of  the    success  of  the 
saline  injections.     At  York   I    was  enabled    to 
visit  the  cholera-hospital,  and  saw  three  or  four 
patients,  among  whom  was  a  boy  aged  seven  or 
eight,  who  had  been  thus  treated  and  was  conva- 
lescent.    How  bad  his  case  had  been,  I  know 
not.     They  assured  me  it  was  very  severe  ;  but 
I  have  seen  so  many   mistakes  upon  this  head, 
that  I  feel  inclined  to  question   the  authority  of 


142  EXTRACTS 

those  who  have  not  seen  more  than  fifteen  or 
twenty  cases,  when  I  know  that,  even   after  an 
accurate  study  of  hundreds,  the  prognosis,  or,  in 
other  words,  the  estimation  of  the  real  severity 
of  a  case,  is  very  difficuh.     Be  that  as  it   may, 
I  am  anxious  and  willing  to  hope  that   this  boy 
recovered  through  the  agency  of  the  saline  treat- 
ment.    I  next  saw  a  young  woman,  aged  twenty- 
two,  who   had   been    three    times    injected,  and 
whose  case  was  accurately  detailed ;  whereby  it 
was  clearly  shown  that  she  was  pulseless,  that 
blood  could  not  be    obtained   at   the    debut,  and, 
from  the  notes,  I  cannot    doubt    that  it   was  a 
severe  case.     Well,  what  was  her  present  state  ? 
You  shall  hear.     They  thought  she  would  pretty 
certainly  recover ;  —  I   would  bet  ten   guineas 
she  is  dead  at  this  moment.     Face  flushed ;  skin 
everywhere  hot ;  lips  and  tongue  getting  dry  and 
brown  ;  respiration  much    embarrassed  ;  a  sort 
of  fainting  or  sighing ;  pulse  one  hundred  and 
twenty,  hard ;  some    disposition    to   drowsiness, 
fell  asleep  while  we    talked   to  her ;  respiratory 
murmur  loud  and  vesicular  in  front ;  could  not 
be  raised  to  examine  her  behind,  where  I  suspect 
we  should  have  found  crepitous  rale.     Compare 
this,  if  you  will,  with  the  cases  of  two  women 
under  Andral,  infirmieres  of  the  hospital,  in  St 


FROM  LETTERS.  143 

Rosaire,  Nos.  20  and  22 ;  their  result  leads  me 
to  anticipate  death  here,"^ 

Again,  in  Leeds,  I  inquired  if  this  treatment 
had  succeeded,  and  was  answered  in  the  nega- 
tive. My  conclusion,  so  far  as  I  am  able  to  form 
one,  is,  that  this  injection  undoubtedly  produces 
a  temporary  excitement,  but  that,  as  yet,  we  have 
no  proof  that  it  arrests  the  disease.  It  does  not 
strike  at  the  cause ;  and  how  can  we  suppose 
that  it  should  ?  This  chemical  rage  enrages  me. 
I  shall  see  medical  gentlemen  here  tomorrow, 
and  learn  what  has  been  their  experience.  You 
shall  have  it  by  the  next  packet. 

^  #  ^  I  have  been  nearly  a  fortnight  reach- 
ing this  place  on  my  way  to  Edinburgh,  and  I 
would  that  every  fortnight  of  my  life  had  been 
as  well  employed.  At  Oxford  we  staid  three 
days  to  see  the  great  men  collected  together  at 
the  British  Association,  in  imitation  of  the  Ger- 
man Society  of  Naturalists.  Of  this,  more  by- 
and-by.  Thence,  through  Leamington,  War- 
wick, Kenilworth,  &c.,  to  Birmingham,  in  each 
of  which  places  I  saw  and  learned  much  that 
was  new  to  me.     Through  Derbyshire,  Derby, 

*  The  reference  here  is  to  the  writer's  "  Cases  of 
Cholera  in  Paris,"  which  he  had  sent  me  a  month  be- 
fore this  letter. 


144  EXTRACTS 

Matlock,  Chatsworth,  Castlcton  into  Yorkshire, 
ShefTicld.  Here  S.  and  I  parted,  much  to  our 
mutual  reirret.  He  is  a  fine  fellow.  I  went  to 
York,  and  to  give  you  an  idea  of  the  hospitality 
which  I  everywhere  experience,  I  will  draw  a 
little  sketch  of  my  Yorkshire  expedition. 

Arrived  at  the  capital  of  this  rich  and  exten- 
sive county,  I  called  on  Mr  K.  with  Mr  W.'s 
letter.  He  and  his  wife  received  me  with  kind- 
ness ;  I  spent  the  evening  and  breakfasted  with 
them  the  next  day.  He  pointed  out  to  me  all 
that  was  interesting  to  a  stranger,  and  introduced 
me  to  Mr  Phillips,  the  curator  of  their  Museum. 
This  gentleman  gave  me  what  I  may  call  a  lec- 
ture of  nearly  an  hour  upon  the  outlines  of 
geology,  of  which  they  have  a  very  fine  cabinet, 
so  arranged  as  to  speak  itself  of  the  beauty  and 
order  of  the  system  ;  and,  I  assure  you,  I  would 
travel  over  twice  the  distance  for  the  sake  of 
gaining  the  clear  view  which  this  gentleman 
gave  me  of  this  interesting  subject.  I  felt  quite 
indebted  to  him  ;  he  has  raised  a  new  cabinet  in 
my  mind,  and  so  raised  it,  that  whatever  accident 
throws  in  my  way,  I  may  easily  attach  there. 
Not  satisfied  with  this  politeness,  he  gave  me  a 
letter  to  the  curator  at  Leeds,  Mr  Hey,  grandson 
of  the  celebrated  Hey.     Here   I   added   to   my 


FROM   LETTERS.  145 

knowledge,  which  was  so  newly  acquired,  and 
was  treated  by  this  gentleman  more  like  an  old 
friend,  whom  he  was  glad  to  see  again,  than  as  an 
entire  stranger.  Had  you  seen  us  together  and 
listened  to  our  conversation  the  next  day,  you 
would  not  have  supposed  our  acquaintance  of 
only  twenty-four  hours'  date.  While  walking 
with  this  gentleman,  he  happened  accidentally  to 
mention  the  name  of  Dr  Teale,  as  a  friend  of 
his.  I  at  once  asked  if  it  was  the  neuralgia  Dr 
Teale.  He  said,  yes,  and  I  begged  to  see  him. 
He  asked  him  to  tea  with  us  ;  we  had  an  hour 
or  two  of  free  pathological  conversation.  Dr 
Teale  promised  to  show  me  some  interesting 
cases  and  morbid  specimens,  if  I  would  stay  and 
dine  with  him  the  next  day.  Though  anxious 
to  get  on,  I  consented  ;  and  glad  am  I  that  I  did. 
Dr  Teale  invited  two  medical  gentlemen  to  meet 
me,  brother  professors  in  their  new  college  in 
Leeds,  and  I  spent  from  four  to  eleven  P.  M. 
most  agreeably  in  their  society.  I  have  not 
talked  so  much  pathology  for  a  long  time.  Dr 
Teale  is  a  very  sensible,  enthusiastic  man  ;  not 
inclined  to  theory  ;  apparently  a  good  and  vigo- 
rous observer ;  industrious  and  well  informed ; 
weighs  and  values  well  his  evidence  before  he 
admits  truth ;  in  fine,  a  man  in  whom  I  should 
10 


146  EXTRACTS 

place  confidence.  You  see  I  passed  a  pleasant 
evening.  ^  ^  =^  I  do  not  regret  passing 
through  Leeds  ;  my  mind  worked  three  days' 
worth,  while  there.  I  learned  some  new  things 
and  had  a  great,  general  review  of  much  patho- 
logical ground.  We  walked  fast,  turned  into 
many  pleasant  lanes  and  bye-paths,  and  midnight 
came  before  I  suspected  it. 

All  this  from  Mr  W.'s  letter  to  Mr  K.  Thus 
it  is  in  England  ;  and  Dr  Teale  begged  m.e  to 
come  again.     How  boundless  is  their  hospitality. 

Of  my  papers  on  cholera ;  of  course  I  am 
anxious  to  know  if  you  will  publish  them.  You 
will  see  that  I  had  to  restrain  a  strong  desire  to 
enter  more  fully  into  the  pathology  of  the  dis- 
ease But  I  am  young ;  and  what  I  have  con- 
demned in  others  who  are  older,  would  have 
been  doubly  guilty  in  myself. 

Mr  F.  calls,  and  I  must  close  to  go  out  with 
him.  Hospitality  again,  hospitality !  Quel 
peuple  ;  je  vante  que  nous  sommes  d'Angleterre. 
J'aime  ce  pays,  comme  notre  mere,  d'ou  vient 
notre  bonheur.     Good  bye,  my  dear  father. 

Your  son,        J.  J. 


FROM    LETTERS.  147 

Edinburgh,  July  10,  1832. 
MY    DEAR    FATHER, 

If  you  are  not  heartily  tired  of  cholera,  I  must 
beg  you  to  read  what  I  have  seen  in  this  city. 
I  was  informed  on  my  arrival,  that  the  disease 
had  re-appeared  here,  and  with  increased  force  ; 
yet  twenty  cases  a  day  is  the  outside.  On  the 
following  morning,  Dr  Alison  introduced  me  to 
the  Cholera  Hospital,  when  I  recognised  the  old 
and  familiar,  but  appalling  features  of  the  mon- 
ster, I  had  so  much  observed  in  Paris.  The 
most  interesting  object  of  inquiry  was,  of  course, 
as  to  the  success  of  the  saline  injection  ;  —  and 
the  following  is,  in  few  words,  the  sum  of  infor- 
mation I  have  been  able  to  obtain. 

It  is  derived  from  several  physicians  of  rank 
here,  and  three  or  four  young  men. 

1.  They  employ  this  remedy  only  in  the  bad 
cases,  viz.  when  the  system  is  prostrated  ;  pulse- 
less, blue,  cold,  &;c.  ;  collapse. 

2.  In  such  cases  the  effect  is  to  produce  ex- 
citement of  the  circulation,  &c. 

3.  After  this  excitement  is  produced,  it  is  some- 
times of  short  duration,  and  recourse  is  had  a 
second  or  third  time  to  the  injection. 

4.  This  excitement  is  sometimes  followed  by 
a  second  collapse,  during  which  the  patients  die. 


148  EXTRACTS 

5.  It  is  again,  and  not  un frequently,  from  their 
statements  I  should  say  very  often,  followed  by 
too  great  a  re-action,  and  the  cases  close  with 
cerebral  symptoms  and  death,  unless  venesection, 
leeches,  &;c.  prove  successful. 

6.  The  efTect  of  this  injection  seems  to  be,  not 
to  cure  the  disease  of  itself,  for,  first,  a  majority  of 
those  injected  die ;  second,  those  who  have  sur- 
vived, most,  if  not  all,  have  taken  calomel  and 
opium  in  full  doses  ;  third,  the  cerebral  affection 
just  noticed,  almost  always  or  very  often  suc- 
ceeds the  injection  and  proves  fatal,  if  it  be  not 
immediately  overcome  by  antiphlogistic  treat- 
ment. 

7.  So  far  as  the  injection  is  proved  to  be  use- 
ful, it  seems  to  be  by  producing  reaction,  and 
thus  allowing  time  for  the  employment  of  alter- 
atives ;  or  bringing  on  the  stage  of  excitement, 
which,  though  very  dangerous,  is  sometimes  to 
be  overcome  by  antiphlogistic  treatment.  This 
last,  which  is  the  result  of  the  observation  of 
these  gentlemen,  coincides  exactly  with  the  opin- 
ion I  expressed  to  you  in  a  letter  from  Liverpool. 
Each  of  these  gentlemen  assured  me,  that  he  did 
not  doubt  having  seen  a,  few  cases  recover  under 
this  treatment,  followed,  as  I  have  before  said,  by 
antiphlogistics  and  alteratives,  which  would  have 


FROM   LETTERS.  149 

proved  fatal  without  the  injection  ;  because  then 
the  last  could  not  have  been  employed. 

8.  The  injection  employed  is  composed  as  fol- 
lows :  R.  Sodas  Muriat.  5  ij,  Sodas  Bicarbonat. 
B  ij,  Aquae  octant:  v,  —  misce.     This  is  used 

at  the  temperature  of  112®  —  Ho® ;  —  its  heat 
is  preserved  during  the  operation,  by  allowing  the 
vessel  containing  it  to  stand  in  another  contain- 
'  ing  hot  water.  The  injection  has  been  contin- 
ued until  the  object  w^as  obtained ;  viz.  return  of 
pulse,  warmth  and  natural  color.  The  opera- 
tion is  performed  with  a  small  syringe,  and  quite 
slowly ;  for  example,  ten  or  fifteen  minutes,  to 
five  or  eight  pounds. 

9.  After  the  injection,  the  following  is  given, 
varying  pro  re  nata  :  R.  Hydr.  Submur.  gr.  iv, 
Op.  gr.  i,  —  misce,  every  two  hours.  I  am  not 
sure  as  to  quantities  and  times,  but  the  object  is  to 
salivate  as  quickly  as  possible,  and  for  this  pur- 
pose mercurial  frictions  are  added.  I  have  said 
nothing  of  vapor  baths,  hot  cloths,  &c.,  w^hich  of 
course,  in  some  form,  are  constantly  employed. 

10.  After  all  this,  they  w^atch  for  reaction,  and 
at  the  first  symptom  of  excess,  bleed  locally  or 
generally. 

11.  One  woman  is  well,  and  now  about,  who 
had  some  time  since  fifty-one  pounds  of  saline 


150  EXTRACTS 

fluid  injected,  besides  a  solution  of  quinine  and 
morphia.  There  were,  of  course,  several  injec- 
tions in  this  case. 

Thus  I  have  given  you,  in  a  hurried  manner, 
(for  my  time  is  much  engaged,)  what  I  believe 
to  be  the  essentials  of  what  I  could  obtain  from 
these  gentlemen.     Yet  once  more. 

12.  Dr  G.  insisted  very  strongly  upon  the  great 
temporary  relief  to  suffering,  even  if  the  cases 
afterwards  proved  fatal ;  saying,  he  should  deem 
himself  culpable  for  neglecting  it,  even  if  this 
were  the  only  ground.  I  shall  next  giv^e  you 
what  I  myself  have  seen,  continuing  a  daily 
report  till  I  send  my  letter. 

[Here  follows  the  records  of  three  cases  treat- 
ed by  injections,  which  are  omitted,  as  not  inter- 
esting at  the  present  day.] 

July  12.  —  =^  ^  I  dined  today  with  Dr  S — , 
he  tells  me  has  used  the  injection  in  eight  suc- 
cessive cases  ;  they  all  were  fatal.  Dr  C.  says 
he  has  seen  it  tried  a  good  deal,  but  is  by  no 
means  sure  of  having  seen  it  once  successful. 

The  truth  is,  that  its  immediate  effects  are  so 
strikino:,  and  there  is  often  in  cholera  such  a  false 
convalescence,  that  it  is  really  very  difficult  to 
prevent  one's  mind  from  receiving  an  impression 
in  favor  of  this  remedy.     "We   see    the   patient 


FROM    LETTERS.  151 

revive  ;  good  pulse,  good  countenance ;  every- 
thing promises  well  for  twenty-four  or  forty-eight 
hours,  and  then  death  soon  follows.  I  have 
already  seen  three  cases  in  Edinburgh,  which 
were  regarded  as  nearly  convalescent,  or  quite 
safe  ;  —  one  of  them  is  dead,  and  I  am  almost 
confident,  from  present  appearances,  the  other 
two  will  die.  I  forgot  to  mention  the  testimony 
of  another  gentleman,  with  whom  I  have  con- 
versed, against  the  injection;  —  Dr  B.  ;  as  also 
Dr  T.,  by  whose  learning  and  familiarity  with 
medical  literature,  late  and  old,  in  such  an  elderly 
gentleman,  I  have  been  as  much  surprised  as 
entertained  and  instructed. 

^  ^  ^  Let  me  suggest  one  measure  to  be 
adopted  in  our  own  dear  city  in  case  the  disease 
reaches  it ;  and  we  have  reports  that  it  is  already 
at  Quebec,  though  God  forbid  it  be  true.  Let 
each  of  our  physicians  take  a  certain  part  of  the 
town  under  his  charge  ;  —  let  it  be  his  duty,  not 
only  to  visit  ail  the  poor  when  they  are  sick,  but 
tioice  a  day,  while  the  disease  remains  ;  let  him 
call  at  each  house,and  inquire  if  any  be  sick,  i.  e., 
have  lost  their  appetite,  have  diarrhoea,  or  any 
premonitory  symptoms  ;  in  this  way  you  will 
get  at  the  disease  early  among  the  poor.  For 
the  rich,  there  is  no  danger  ;    they  will  call   you 


152  EXTRACTS 

from  your  beds  often  enough,  with  false  alarms 
and  vain  fears.  If  you  wait  for  the  poor  to 
come  to  you,  it  will  be  too  late ;  you  must,  there- 
fore go  to  them  ;  and  the  labor  will  not  be  great, 
when  divided  among  so  many.  I  know  of  no 
means  so  likely  to  lessen  the  mortality. 


Dublin,  August  19,  1832, 
MY    DEAR  FATHER, 

I  would  to  God  I  knew  how  it  is  with  you  at 
this  moment.  When  awake,  I  do  not  allow  my- 
self to  think  much  of  cholera  in  America,  and 
never  to  fancy  that  my  friends  can  be  touched 
by  it; — but  in  sleep,  it  occurs  in  my  dreams, 
and  they  are  such  as  sometimes  alarm  me.  I 
must  await  the  end.  I  have  not  received  any 
letters  from  you  for  some  time  ;  — as  I  have  been 
wandering  and  uncertain,  I  directed  them  to  be 
detained  at  London,  after  I  left  Edinburgh,  and 
this  circumstance  will  hurry  me  back  to  London. 
I  am  already  repaid  for  coming  to  this  city,  by 
a  few  hours'  study  yesterday  at  the  museum  of 
pathological  anatomy,  at  the  college  of  surgeons. 
I  have   added  to  the  stores  of  my   knowledge, 


FROM    LETTERS.  153 

memory  and  note-books  upon  this  subject.  It  is 
my  intention,  so  to  have  seen  everything  in  the 
morbid  ivay^  that  you  cannot  find  me  at  fault  on 
the  most  close  examination.  I  have  already  seen 
much,  that  from  books  I  had  longed  for,  and  only 
regret  that  you  are  not  at  my  side,  that  we  might 
burn  together,  as  we  looked  upon  the  riches  of 
the  science  we  love.  Do  not  imagine  that  I  am 
going  to  allow  myself  to  become  a  mere  patho- 
logical anatomist,  instead  of  a  pathologist  in  the 
more  liberal  sense  of  the  word.  .  Eemember, 
though  I  now  write  mainly  of  specimens,  prepa- 
rations and  paintings,  that  from  Paris  I  wrote 
much  of  symptomatology,  aye,  and  studied  it 
much,  too.  That  I  do  not  much  expect  in  Eng- 
land ;  —  it  is  almost  impossible.  I  may  see 
practice,  you  will  say ;  I  will,  but  I  expect  fully, 
very  often  to  be  much  in  doubt  as  to  the  nature 
of  the  case,  in  which  the  practice  is  exercised. 

I  was  very  much  delighted  with  the  Giant's 
Causeway,  of  which  I  would  give  you  a  descrip- 
tion, but  that  in  print  you  will  find  so  many 
superior  to  anything  I  can  give  you.  The  coun- 
ties of  Antrim,  Downe,  Derry,  &c.,  in  the  north 
of  Ireland,  through  which  I  rode,  are  beautifully 
cultivated ;  and  in  them  are  some  of  the  neat- 
est, best  built  villages  I  have  ever  seen,  inhab- 


154  EXTRACTS 

ited  by  people  whose  dress,  countenance  and 
whole  aspect,  indicate  comfort  and  prosperity. 
The  mud  hovel  is  there  scarcely  to  be  seen.  In- 
deed, to  my  eye,  these  little  towns  are  superior, 
most  decidedly  to  most  of  those  I  passed  through 
in  Scotland,  either  north  of  Edinburgh,  or  west 
of  it.  Such  an  appearance  of  prosperity  and 
comfort  in  Ireland,  was  to  me  as  surprising  as  it 
was  grateful ;  for  I  don't  forget  my  Tracy  blood  ; 
—  but  I  am  told,  that  at  the  south  it  is  quite  dif- 
ferent ;  and  if  I  can  possibly  get  three  or  four 
days,  I  shall  ride  through  it  to  see  for  myself. 
I  am  here  struck,  as  I  was  in  Switzerland,  with 
the  difference  between  the  protestant  and  catholic 
counties  ;  —  the  first  prosperous,  the  last  wretch- 
ed J  in  the  first,  rich  fields  and  good  roads,  indi- 
cating that  time  was  precious  and  well-spent 
also  ;  —  the  last  uncultivated,  or  poorly  so,  with 
bad  roads  ;  a  token  of  the  very  opposite.  I  can- 
not forget  having  made  the  same  remarks  some 
years  since,  when  travelling  from  New  England 
into  catholic  Canada. 

The  anatomical  department  at  the  College  Sur- 
gical Museum,  is  so  arranged  here,  and  with  so 
excellent  a  catalogue,  that  with  a  little  study  I 
may  fix  some  very  important  general  principles) 
illustrated  by  preparations  on  the  subject  of  com- 


FROM   LETTERS. 


155 


parative  anatomy  of  the  internal  organs.  I  shall 
devote  as  much  time  as  possible  to  this,  after  I 
have  finished  the  morbid  anatomy  :  —  every  spe- 
cimen of  which  I  examine,  taking  a  note  of  all 
that  is  new  or  peculiar. 

The  finest  institution  I  have  yet  seen  in  Eu- 
rope, is  the  Lying-in-Hospital  in  this  city  ;  —  it 
is  very  extensive,  extremely  neat  and  comforta- 
ble, almost  vying  with  the  Massachusetts  Gene- 
ral Hospital ;  and  I  should  imagine  more  truly 
useful  than  almost  any  other,  as  affording  cer- 
tain and  positive  relief  to  sufferings,  which, 
uncomplicated  with  cold  and  hardship,  are  suffi- 
ciently severe.  I  trust  we  shall  soon  have  a 
similar  institution.  I  shall  endeavor  to  procure 
what  I  can  of  the  regulations  and  reports  of  this, 
so  far  as  they  have  been  published.  The  citi- 
zens, especially  the  professional  men,  are  extreme- 
ly, and  very  justly  proud  of  this,  their  favorite 
establishment. 

As  to  cholera,  the  experience  of  the  gentlemen 
I  have  conversed  with  here  is  the  same  as  else- 
where, viz.  that  art  is  vain  against  it.  I  have 
seen  one  new  thing  upon  this  subject;  —  a  pa- 
tient of  Mr  Cusack's,  in  whom  mortification  of- 
half  of  both  feet  followed  the  disease.  He  has 
seen  a  second  case  of  the  same.     They  have  suf- 


156  EXTRACTS 

fered  here  most  sadly,  but  the  cases  are  now 
reduced  to  six  or  eight  a  day.     ^  =^  ^ 

Aug.  21.  Still  in  Dublin,  my  dear  father ; 
neither  do  I  regret  it.  I  have  picked  up  a  good 
deal  at  the  museum,  —  having  examined  each 
specimen  of  morbid  anatomy ;  and  a  fine  collec- 
tion it  is,  though  there  are  defects. 

The  collection  of  comparative  anatomy  of  the 
internal  organs  is  so  admirably  arranged,  cata- 
logued, described  and  labelled,  that  I  cannot 
resist  the  opportunity  to  study  the  subject  by 
means  of  it,  and  with  text  book  in  hand,  am  now 
employed  in  examining  with  care  these  speci- 
mens. My  thoughts  are  now  on  tongues  and 
stomachs,  instead  of  diseased  hearts,  &c.  I  can 
learn  more  from  this  than  from  J.  Hunter's  even, 
because  there  is  neither  catalogue  nor  label, 
there.  —  Again,  this  will  prepare  more  for  the 
other. 


London,  September  14,  1832. 
I  have  today  finished  my  study  of  the  muse- 
um at  Guy's,  which  has  cost   me  many   hours. 
It  is  certainly  the  finest  I  have  seen  in  Europe, 


FROM   LETTERS.  157 

and  does  great  honor  to  Dr  Hodgkin  ;  who,  by 
the  by,  is  one  of  the  deepest  men  in  reading  and 
observation  that  I  have  seen.     ^  =^  ^ 


London,  September  22,  1832. 
MY    DEAR    FATHER, 

I  received  a  few  days  since  yours  of  August 
20,  —  Cholera  had  just  commenced  ;  —  sloioly  ; 
—  how  has  it  been  since  ?  I  anxiously  await  the 
arrival  of  papers  to  inform  me.  It  is  useless  to 
speculate  upon  it ;  I  cannot  but  hope  and  believe 
that  the  precautions  and  general  character  of 
the  Bostonians  (than  whom  I  have  seen  no  peo- 
ple at  home  or  abroad,  more  marked  for  solidity 
of  judgment  and  good  common  sense)  will  pre- 
vent it  from  being  excessively  severe.     =^  =^  ^ 

^  #  ^  ]VIy  purposed  occupation  for  the  week, 
the  examination  of  Hunter's  museum,  has  been 
interrupted  by  a  most  melancholy  accident.  ^  ^ 

It  is  truly  grievous  that  there  is  no  catalogue 
of  this  superb  collection,  —  I  would  give  more 
for  one  during  the  next  fortnight  than  for  any 
book  I  know  of.  —  I  can  understand  the  general 
plan,  and  many  of  the  individual  specimens;  — 


158  EXTRACTS 

the  more  from  having  studied  as  I  did  at  Dublin. 
The  more,  too,  I  could  have  said,  had  I  stud- 
ied as  I  ouofht  to  have  done  at  the  Garden  of 
Plants.  And  when  I  can  understand  the  pecu- 
liar object  of  an  individual  specimen,  it  is  so 
beautiful  and  so  demonstrative,  so  speaks  of  its 
great  Designer,  that  I  am  only  the  more  vexed 
that  the  greater  part  are  as  a  dead  letter.  You 
can  judge  of  the  immense  disadvantages  under 
which  I  must  study  it,  and  the  comparatively 
little  knowledge  I  can  obtain  from  it,  when  I  de- 
scribe to  you  in  what  manner  a  catalogue  is  now 
being  made  by  Mr  Owen.  He  has  devoted  him- 
self to  this  task  for  the  last  year  and  a  half,  and 
really  his  zeal  and  industry  are  quite  proverbial. 
Well,  in  this  year  and  a  half  he  has  advanced 
about  four  hundred  specimens  ;  just  about  be- 
ginning with  the  organs  of  digestion  now.  In 
order  to  this,  he  tells  me  he  has  already  dissected 
more  than  two  hundred  species  of  animals.  His 
only  resources  are  a  very  meagre  catalogue  of 
Hunter's,  which  is  so  mingled  with  a  false   and 

pretended  one  by as  to  render  its  authority 

very  doubtful.  When  he  does  not  know  a  spe- 
cimen, therefore,  he  begins  to  dissect  all  the  ani- 
mals from  which  he  has  reason,  from  his  previ- 
ous knowledge  or  reading,  to  suspect  that  it  was 


FROM  LETTERS.  159 

taken.  He  tells  me  he  has  sometimes  dissected 
thirty  animals  to  ascertain  a  single  specimen. 
By  so  doing  he  is  constantly  adding  to  the  riches 
of  the  museum ;  but  the  fact  that  this  is  neces- 
sary will  show  you  how  lamentably  limited  must 
be  the  advantages  I  can  enjoy  in  this  study. 
Yet,  as  I  tell  you,  I  find  myself  able  to  recog- 
nise many  things,  which  would  have  been  a  per- 
fect secret  to  me,  but  for  my  study  at  Dublin. 
Again,  that  study  teaches  me  how  vastly  superior 
is  this  museum  of  Hunter's,  though  much  less 
useful  to  the  student  from  the  want  of  a  cata- 
logue.     "^  ^  "^ 

^  ^  ^  I  have  just  come  from  Bartholomew's 
hospital,  where  I  have  seen  Lawrence,  Earle, 
&c.,  and  the  museum,  which  is  small,  but  neat 
and  instructive,  —  mostly  devoted  to  surgical 
diseases.  In  it  is  a  specimen  of  diseased  lung, 
similar  to  one  at  Guy's,  in  which  emphysema 
exists  to  a  very  marked  degree,  with    tubercles. 

I  think  I  wrote  you  of  a  puzzling  case  in 
Louis's  ward  last  spring,  where  I  could  not  come 
to  a  diagnosis  of  anything  but  a  combination  of 
these  two  affections.  These  two  specimens  have 
been  very  interesting  to  me,  as  proving  the  coin- 
cidence of  the  two  things,  and  rendering  the 
diagnosis  probable. 


160  EXTRACTS 

London,  September  23,  1832. 

Would  you  were  here,  my  dear  father,  to  enjoy 
with  me  the  study  of  John  Hunter's  works,  and 
to  kindle  with  me  in  my  admiration  of  his  ge- 
nius ;  the  elevation  and  extent  of  which  I  know 
not  even  now  ;  nor  does  any  man  living,  though 
my  conceptions  of  his  vast  and  comprehensive 
mind  have  been  greatly  elevated  within  the  last 
fortnight.  His  museum  is  intelligible  to  no  one 
in  its  full  extent.  The  materials  there  collected 
and  arranged,  are  often  indicative  of  peculiar 
ideas,  which  are  lost  to  the  world  for  want  of 
their  great  interpreter.  This  is  especially  true 
as  I  suspect,  upon  the  subject  of  generation, 
on  which  the  museum  is  peculiarly  rich  in  the 
number  and  variety  of  its  preparations.  Diges- 
tion, respiration  and  generation  have  been  the 
most  interesting  departments  to  me  ;  and  beauti- 
ful indeed  is  the  endless  variety  of  means  to  ob- 
tain these  several  ends,  varying  as  they  always  do 
in  accordance  with  the  nature  and  circumstances 
of  the  individual  cases.  The  collection  at  Dub- 
lin, on  the  subject  of  circulation,  is  even  better  than 
that  of  Hunter's,  so  that  I  did  not  meet  with  so 
much  that  was  new  to  me  on  that  score.  While 
visiting  the  museum,  I  have  been  reading  those 
valuable  papers  in  Hunter's  work  on  the  animal 


FROM    LETTERS.  161 

economy,  which  Dr  Hodgkin,  among  his  numer- 
ous other  kindnesses,  procured  for  me.  Will 
you  believe  it,  in  London,  the  theatre  of  this 
great  man's  life,  I  found  considerable  difficulty 
in  procuring  this  work.  ^  ^  ^ 

#  ^  ^.  Sept.  29.  Let  me  give  you  an  ac- 
count of  some  new  ideas  of  Dr  Carswell's  upon 
the  seat  of  tubercles,  which  he  has  been  unfold- 
ing and  illustrating  to  me  this  morning.  I  am 
anxious  to  keep  his  arguments  in  mind,  and  can- 
not do  better  than  write  them  you  ;  —  the  present 
exercise  will  impress  them  upon  my  mind,  and 
the  sheet  will  serve  me  for  notes  at  my  return. 


London,  October  l,  1832. 
^  ^  ^  I  dined  with  Dr  M.  Hall,  and  was 
indebted  to  him  for  one  of  the  grandest  specta- 
cles that  human  eye  can  behold.  I  witnessed 
the  circulation  in  the  web  of  a  frog,  under  a  mi- 
croscope of  one  hundred  magnifying  power.  — 
I  know  not  whether  you  have  ever  seen  this  or 
not ;  if  not,  you  have  no  conception  of  its  beauty. 
With  what  ideas  does  it  fill  the  mind  I  —  the 
whole  animal  world  thus  teeming  with  life  and 
11 


162 


EXTRACTS 


motion,  and  this  motion  in  the  most  defined  and 
regular  vessels,  and  regulated  by  unvarying  laws. 
The  artery  is  distinct,  constantly  dividing  into 
smaller  arteries,  until  it  is  at  last  separated  into 
two  capillary  vessels.  These  are  always  of  the 
same  size,  and  thus  differ  from  the  arteries  in 
this  respect.  They  run  in  every  direction  and  at 
last  terminate  in  veins,  between  which  and  them- 
selves, as  to  form  and  size,  there  is  again  the 
same  distinction.  In  the  second  place,  the  blood 
is  seen  to  move  with  different  velocities  in  each 
of  these  three  order  of  vessels.  As  it  courses 
its  way  along  the  artery,  rapid  as  lightning,  you 
cannot  distinguish  the  globules  ;  these  become 
quite  apparent  in  the  capillaries,  and  yet  more 
so,  I  thinks  in  the  veins ;  at  any  rate,  you  see 
them  very  distinctly  in  these  two  last  series  of 
vessels,  whereas,  in  the  arteries,  they  succeed 
each  other  so  rapidly,  as  to  form  a  continued  line 
to  the  eye.  It  is  a  most  glorious  sight,  and  most 
ennobling  to  see  the  blood  thus  actively  pursuing 
its  course  till  it  reaches  the  great  and  common 
reservoir,  the  capillaries ;  there  delaying  its 
progress  in  order  that  the  formative  vessels  may 
make  what  use  of  it  they  will ;  and  then  slowly 
making  its  way  back  to  the  organs,  where  it  is  to 
be  replenished  with  what  it  has  lost,  or  give  up 


FROM   LETTERS.  163 

what  it  has  acquired.  When  the  web  was  wet 
with  alcohol,  and  inflammation  had  commenced, 
the  capillary  circulation  stopped  entirely  after  a 
while  ;  the  blood  was  stagnant  in  these  vessels, 
while  it  continued  to  flow  in  the  others.  Upon 
this,  (which  is  a  phenomenon  I  know  to  be  true, 
for  I  saw  it,)  Dr  Hall  forms  an  hypothesis  con- 
cerning inflammation. 


Paris,  November  1,  1832, 

^  ^  ^  The  glory  of  the  week  has  been  An- 
dral's  introductory  lecture  on  diseases  of  the 
brain.  It  was  the  most  eloquent  I  ever  heard, 
one  speech  of  Mr  Webster's  and  a  sermon  or  two 
of  Dr  Channing's  excepted.  I  could  scarcely 
restrain  myself,  it  was  so  grand  and  beautiful. 
What  powers  of  mind  and  vastness  of  compre- 
hension has  this  man  !  What  gave  me  peculiar 
pleasure  also,  he  declared  boldly  and  freely  for 
the  numerical  method,  saying,  it  was  the  only 
mode  of  advancing  the  science  of  pathology. 


164  EXTRACTS 

Paris,  November  13,  1832. 
*  #  #  What  Louis  has  given  us  is  positive, 
and  it  is  a  matter  of  astonishment  to  see  to  what 
beautiful   and   unexpected  results  his  mode  of 
studying  has  led  him.     Will  you  have  an  exam- 
ple, now  before  my  eyes  ?     I  could  give  many, 
but  will  limit  myself  to  the  following.     One  of 
his  laivs,  drawn  from  the   study  of  his  facts,  is, 
that  in  the  adult  subject  whenever  tubercles  exist 
in  any  part  of  the  body,  they   of  necessity  exist 
also  in  the  lungs.     A  second  laio  is,  that  every 
chronic  peritonitis,  chronic  from  its  debut,  is  tuber- 
culous ;  i.  e.  he  has  never  seen  one  that  was  not 
so.     Ergo,  if  one  discovers  by  symptoms,  during 
life,  a  chronic  peritonitis,  one  may  be  sure  that 
the    patient   is    tuberculous,   and   that  he  has  a 
tuberculous  affection  of  the  lungs ;   and  he  may 
safely  diagnosticate    this,  although    there   may 
be   no    symptoms  whatever   of  pulmonary  dis- 
ease.    I   must  have  Avritten   you    last  year  of 
one   case,  in   which  I  saw  him  make   the  diag- 
nosis correctly.     A  second  is  now  in  the  ward, 
of  which   I   will   give   you   the  details    on  my 
return,  as  I  have  taken  the  observation  at  Louis's 
request.     To  me  the  case  is  interesting  in  anoth- 
er view,  as  being  one  of  those,  of  which  I  wrote 
you  in  my  last,  where  I  had  observed    the   form 
of  bronchial  expiration  then  alluded  to. 


FROM    LETTERS.  165 

Paris,  November  24, 1832. 

#  #  #  Morbid  anatomy,  then,  does  not  tell  us 
all ;  far,  far  from  it ;  and,  I  may  add,  that  if  I 
have  learned  better  to  appreciate  what  this 
science  can  teach  us,  by  a  more  extended  obser- 
vation than  it  was  possible  for  me  to  enjoy  in 
America,  I  have  not  the  less  learned  that  it  is  by 
no  means  the  only  mode  in  which  we  are  to 
study  the  intricacies  of  pathology.  How  much 
chemistry  is  to  yield,  how  much  a  more  inti- 
mate knowledge  of  physiology,  how  much  a 
more  exact  appreciation  of  the  various  influences 
of  the  different  physical  agents  upon  us,  it  re- 
mains to  be  decided.  This  last  subject  interests 
me  much  at  this  moment,  as  I  am  now  reading 
Edwards'  work  on  the  influence  of  the  physical 
agents  upon  life ;  one  of  the  most  remarkable 
works  I  have  ever  read,  both  on  account  of  the 
subject,  and  the  peculiarly  vigorous  and  philo- 
sophical mind  of  the  author.  I  hope  to  see  him 
soon  ;  Dr  Bostock  gave  me  a  letter  to  him.  But 
our  poor  pathology  and  yet  worse  therapeutics  ; 
shall  we  ever  get  to  a  solid  bottom  ?  shall  we 
ever  have  fixed  laws  ?  shall  we  ever  know.,  or 
must  we  be  ever  doomed  to  suspect,  to  presume  ? 
Is  perhaps  to  be  our  qualifying  word  forever  and 


166  EXTRACTS 

for  aye  ?  Must  we  forever  be  obliged  to  hang" 
OUT  heads,  when  the  chemist  and  natural  philos- 
opher ask  us  for  our  laws  and  principles  ?  Must 
we  ever  blush  to  see  the  book  of  the  naturalist, 
his  orders  and  his  genera,  with  their  character- 
istics invariable^  w^hile  we  can  point  to  nothing 
equivalent  ?  Our  study  is  that  of  nature,  as  well 
as  theirs  ;  the  same  cause  acting  upon  the  same 
materials  must  ever  produce  the  same  effect  with 
us,  as  with  them.  But  they  know  all  their  ele- 
ments. Do  we  ?  In  their  calculation  no  figure 
need  be  left  out.  Is  it  so  with  us  ?  If  honest, 
must  we  not  confess  that  we  are  ignorant  of  ma- 
ny circumstances,  which  must,  however,  vary  the 
result  ?  [f  honest,  must  we  not  acknowledge 
that,  even  in  the  natural  history  of  disease,  there 
is  much  very  doubtful.,  which  is  received  as  sure  ? 
And  in  therapeutics,  is  it  better  yet,  or  worse  ? 

Have  we  judged,  have  we  deduced  our  results, 
especially  in  this  last  science,  from  all.,  or  from  a 
selection  of  facts  ?  Do  we  know,  for  example,  in 
how  many  cases  such  a  treatment  fails  for  the 
one  time  it  succeeds  ?  Do  we  know  how  large 
a  proportion  of  cases  would  get  well  without  any 
treatment,  compared  with  those  which  recover 
under  it  ?  Do  not  imagine,  my  dear  father,  that 
I  am  becoming  a  sceptic  in  medicine  ;  it  is  not 


FROM    LETTERS. 


167 


quite  so  bad  as  that ;  —  I  shall  ever  believe  at  least 
that  the  rules  of  hygeia  must  be  and  are  useful, 
and  that  he  only  can  well  understand  and  value 
them,  who  has  well  studied  pathology.     Indeed, 
I  may  add  that,  to  a  certain  extent,  I  have  seen 
demonstrated  the  actual  benefit  of  certain  modes 
of  treatment  in  acute  diseases.     But  is  this  ben- 
efit immense  ?     When  life  is  threatened,  do  we 
very  often  save  it  ?     When  a  disease  is  destined 
by  nature  to  be  long,  do  we  often  very  materially 
diminish  it  ?     I  doubt  not,  that  we  do  sometimes 
and  under  certain  circumstances.     But  on  the 
other  hand,  I  must  acknowledge  that,  what  I  have 
seen  here  of  disease  and  its  issues,  has  rather 
inclined  me  to  believe  that  I  individually  over- 
valued the  utility  of  certain  modes  of  treatment 
in  America.     You  cannot  conceive  of  my  im- 
patience to  get  home  and  see  again,  what  I  once 
saw,  and  what  a  second  time  I  shall  look  at  with 
new  eyes.     I  have  been  led  into  these  reflections 
(and  I  hope  you  will  read  them  as  they  are,  pass- 
ing, conflicting  doubts,   which  must  ever   arise 
in  the  mind  of  man  on  every  subject,  upon  which 
he  has  not  determined  facts,  as  the  basis  of  his 
opinion)   by  the  study  of,  or  rather  the  look  I 
have  been  taking  at  physics  and  chemistry  and 
natural  history. 


168 


EXTRACTS 


I  have  been  led  into  them  too,  by  the  study  of 
these  darkest  of  all  dark  subjects,  diseases  of  the 
brain.  There  I  look  in  vain  for  a  constant  and 
fixed  effect,  so  far  as  our  senses  and  present  modes 
of  exploration  enable  its  to  appreciate  the  causes 
and  the  effects.  There,  again,  even  after  we  5ec?7z 
to  have  fixed  upon  some  almost  characteristic 
distinctions,  which  will  translate  with  compara- 
tive certainty  the  causes,  I  am  condemned  to 
read  that  having  thus  discovered  the  cause,  we 
can  go  no  further.  There  is  a  ramollissement, 
there  is  a  tumor ;  but  we  can  remove  neither. 
There  is  a  haemorrliage ;  but  some  facts,  of  which 
I  have  been  eye-ioitness,  teach  me  that,  even  with- 
out treatment,  these  sometimes  advance  toward 
a  certain  degree  of  cui'e,  and  the  symptoms 
thereof  disappear  to  a  certain  extent;  and  beyond 
that,  the  art  of  man  can  never,  or  almost  never 
go :  the  lesion  remains ;  the  individual  is 
maimed  for  life,  and  that  life  is  not  worth  the 
having.  Is  it  not  true,  my  dear  father  ?  Your 
life,  which  has  been  so  long  and  so  extensively 
useful,  has  it  not  been  so  more  through  hygienic, 
prophylactic,  than  through  strictly  therapeutic 
means  ? 

Think  for  a  moment  of  the    diseases,  which 
prove  fatal  to  the  life  of  man  in  our  country.  — 


FROM   LETTERS.  169 

Probably  nearly  a  fourth  die  of  tubercles ;  cer- 
tainly a  fourth,  if  we  except  those  who  die  of 
old  age.  After  this  fourth,  how  large  a  propor- 
tion dies  of  some  confessedly  incurable  organic 
disease. 

Will  you  know  to  what  results  reflections  of 
this  sort  have  driven  me  ?  I  am  brought  to  think 
that  the  medical  man's  life  may  be  most  usefully 
spent  in  the  collection  of  facts,  which  shall  throw 
light  upon  the  causes,  internal  and  external,  (I 
mean  those  which  exist  within  and  around  the 
individual,)  producing  or  leading  to  organic  dis- 
eases, tubercles  and  the  rest.  How  can  this  be 
done  and  what  will  be  its  effects  ?  Let  me  say 
a  word  upon  each  of  these  heads.  It  can  be 
done,  well  done,  scientifically  done,  in  one  way 
only.  Numerous  histories  of  the  lives  of  indi- 
viduals, from  the  uterus  to  the  grave,  must  be 
carefully  collected.  Their  weight,  and  size,  and 
parentage  ;  their  comparative  growth  and  devel- 
opment;  the  care  of  their  infancy;  length  of 
time  at  the  breast,  &c. ;  their  mode  of  physical 
education  as  to  diet  and  exercise  ;  and  their  dis- 
eases, all  in  detail ;  their  idiosjmcrasies  in  every 
particular  ;  and  a  host  of  things,  which  appertain 
to  every  individual  and  influence  his  physical 
existence. 


170  EXTRACTS 

This  cannot  be  done  by  one  man ;  —  there 
must  be  a  society,  —  a  body  of  men,  all  impress- 
ed with  a  sense  of  its  importance,  all  feeling 
and  knowing  that  without  it  we  cannot  reach 
truth.  Reflect  for  a  moment  upon  the  delights 
of  such  an  association.  Suppose  there  were  ten 
of  us  in  Boston  and  its  environs,  who  should 
thus  associate  and  observe  carefully  during  ten 
years  or  twenty  ?  We  begin  with  the  children, 
who  are  born  under  our  care  ;  each  of  us  keeps  a 
record  of  all  thus  belonging  to  him;  these  rec- 
ords are  to  be  copied  by  a  clerk  into  a  book, 
which  is  the  property  of  the  society.  Each 
month  we  meet  together ;  the  subject  of  the 
evening  is  the  additional  material  during  the 
past  month,  which  appears  upon  the  pages  of 
our  book.  What  would  be  the  advantages  of 
such  a  society  ?  Call  it  Utopian,  call  it  ideal,  if 
you  will ;  I  '11  not  deny  it.  I  fear  it  may,  nay, 
perhaps,  must  be  so  ;  but  again  I  ask,  what  might 
be  the  advantages  of  such  a  society  ? 

1.  We  meet,  so  many  students^  so  many  prac- 
titioners, all  inspired  with  the  holy  desire  to  dis- 
cover truth  and  to  turn  it  to  advantage.  We 
meet,  each  presenting  to  the  whole  what  has 
occurred  to  him,  receiving  the  light  and  aid  which 
the    combined  efforts   of   the  whole  can  afford. 


FROM    LETTERS. 


171 


Every  individual  case,  then,  of  disease  will  be 
more  fully  considered  and  have  an  opportunity 
of  being  better  treated.  2.  We  create  a  school 
of  accurate  observers,  and  the  good  effects  of  this 
alone  are  endless.  3.  We  amass  materials, 
from  which  may  be  deduced  a  good  and  connect- 
ed general  history  of  the  most  unknown  diseases, 
those  of  children,  not  painted  by  the  imagination, 
but  rigorously  deduced  from  facts.  4.  We  col- 
lect in  time  a  vast  quantity  of  material,  which 
shall  go  to  prove  incontestably  some  of  the  most 
important  points  of  hygiene.  We  show,  for 
example,  that  children  nursed  only  ten  months 
have  only  half  the  chance  for  a  continuance  of 
life  to  the  adult  age  that  those  have,  who  are 
nursed  sixteen  or  eighteen.  We  show  that  of 
two  families,  equally  disposed  to  phthisis,  in  one, 
who  from  infancy,  led  an  inactive  life,  &c.,  all 
are  dead  at  an  early  age  ;  while  in  the  other, 
where  means  were  taken  to  invigorate  the  sys- 
tem, all  live,  &c. 

We  will  suppose  that  these,  or  similar  and 
equally  important  truths,  could  be  rigorously 
deduced  from  the  facts  we  had  collected  ;  that 
we  could  prove  them,  and  show  our  proof  to  the 
world,  as  the  public  treasurer  renders  his  annual 
account   to  the   public,  by  figures  and  columns 


172  EXTRACTS 

not  to  be  mistaken.  5.  Again,  in  tlius  learning 
what  description  of  individuals  and  what  sort  of 
life  predisposed  to  such  and  such  diseases,  we 
may  arrive  at  an  earlier  diagnosis,  and  thus  be 
able  to  procrastinate,  if  we  cannot  prevent  the 
occurrence  of  disease.  But  the  advantages,  both 
to  the  parties  and  to  the  public,  which  might 
result  from  such  a  course  are  too  obvious. 

I  have  shown  how  I  think  this  may  be  done 
and  what  would  be  some  of  its  effects  ;  but  there 
is  yet  another  and  a  more  important  one  in  my 
mind  than  any,  which  would  be  produced  imme- 
diately upon  and  through  the  physician.  I  speak 
of  the  effect  upon  the  public  mind,  —  the  influ- 
ence it  would  upon  the  education  of  youth  and 
the  public  hygiene  in  general.  What  mother 
would  dare  tear  her  child  from  the  breast  at 
eight  or  ten  months,  after  we  had  shown  her  and 
made  it  accepted  truth,  that  one  of  two  children 
thus  treated  would  meet  with  a  premature  death  ? 
How  many  parents  would  be  stimulated  to  in- 
crease their  efforts  to  give  vigor  to  their  children, 
when  it  was  made  as  clear  as  that  twice  two  is 
four,  that  without  it  a  wretched  life  and  an  early 
death  would  be  the  consequence  ! 

I  may  deceive  myself  upon  this  subject ;  — 
though  I  have  not  yet  Avritten  you  half  I  feel  and 


FROM    LETTERS.  173 

think ;  —  I  may  overvalue  its  advantages ;  but 
on  my  honor,  I  do  now  believe  it  would  be  both 
for  science,  pure  science,  for  utility,  and  conse- 
quently for  the  only  two  highest  ends  of  action 
to  men  in  our  profession,  the  noblest  thing  that 
could  be  done.  Imagine,  for  a  moment,  that 
such  a  society  should  spread  from  its  little  centre 
at  Boston ;  that  after  a  few  volumes  from  New 
England,  Philadelphia  and  New  York,  then 
London  and  Edinburgh,  &;c.,  should  raise  their 
societies  ;  —  that  the  work  should  go  on  ;  — look 
forward  only  fifty  years  ;  —  imagine  a  man  like 
Andral  to  bring  together  and  to  extract  the  truth 
from  the  immense  mass  of  materials  collected  : 
would  there  not  be  truth  and  useful  truth  there  ? 
To  set  such  a  wheel  in  motion  would  it  not  be  to 
have  been  useful  ?  1  long  to  talk  with  you  upon 
this  subject,  my  dear  father.  For  two  months  past 
it  has  occupied  many  a  musing  hour  in  my  mind. 
And  yet  I  beg  you  '11  say  nothing  of  it.  Don't 
think  me  crazy ;  I  don't  expect  all  that  I  write. 
I  only  hope  that  an  idea  has  struck  me  which  is 
practicable,  and  if  practised  will  lead  to  good. 


174  EXTRACTS 

Paris,  Dece3ibeb  26,  1832. 

^  *  ^  Having  made  this  accurate  analysis  of 
the  characters  of  this  morbid  part,  and  having 
arrived  at  this  more  nette  idea,  than  I  ever  had 
before,  of  the  true  distinction   of  the   first  stage 
of   inflammation  from  mere  congestion,  I  was 
proud  and  delighted  ;  showed  it  to  my  friends ; 
repeated  it  half  a  dozen  times,  and  do  not  abstain 
from  writing  you  in  full,  for  I  was  truly  happy 
over  it.     I  pray  keep  the  letter.     You  may  say 
I  should  have  known  it  before,  but  if  you  look 
at  my  cases  of  cholera  described  by  Louis  and 
Andral,  or  at  Laennec,   or  at  Andral's  clinique, 
you  will  see   that  nowhere    is  the  thing  drawn 
out  so  clearly  as  I  have  done  it  in  the  last  page, 
by  comparing  together  the  two  lungs. 


Paris,  January  16,  1833. 
^  ^  #  In  very  truth  I  look  forward  with  fear 
and  trembling  to  the  day  when  I  must  employ 
my  time  to  earn  money,  instead  of  to  learn  truth. 
I  once  laughed  when  I  was  told  the  student's  is 
the  happiest  life.  Persuaded  as  I  am  that  there 
is  very  much  in  the  exercise   of  our  profession, 


FROM   LETTERS.  175 

that  developes  and  satisfies  the  affections,  —  that 
delights  the  moral  man,  —  yet  I  must  acknow- 
ledge that,  had  circumstances  favored  it,  I  should 
have  been  pleased  to  pass  at  least  eight  or  ten 
years  in  the  study  of  the  sciences  of  pathology 
and  therapeutics,  in  the  hopes  of  establishing 
some  important  truths.  I  am  afraid,  my  dear 
father,  that  we  are  in  the  habit  of  regarding 
many  things  in  both  these  sciences  as  axioms, 
which  are  very  far  from  being  proved.  As  an 
individual  I  can  be  satisfied  of  a  therapeutic  truth 
but  in  one  of  two  modes.  1.  I  must  see  the 
treatment  employed  in  a  large  number  of  cases, 
which  are  in  no  way  selected;  I  must  know  and 
observe  all  the  peculiarities  of  the  disease,  not 
only  so  as  to  know  what  it  is  ;  but  what  is  the 
history  and  nature  of  the  individual  who  has  it, 
the  history,  or  the  general  issue  of  the  diseases 
of  the  season,  &c.  &c.  These  cases,  being  col- 
lected, are  my  raw  material ;  I  must  study  and 
class  them.  I  must  then  count  and  see  how  often 
under  such  and  such  circumstances  the  treatment 
has  been  successful.  This  I  have  never  done 
with  regard  to  any  disease  but  cholera  ;  but  until 
it  is  done,  my  belief  as  a  scientific  man,  is,  and 
must  be  insufficient  to  satisfy  my  mind.  Such 
evidence  is  not  necessary  to  prove  that  relief  of 


176  EXTRACTS 

symptoms  follows  treatment  of  various  sorts  ;  — 
of  this  no  one  can  doubt ;  he  sees  it,  who  looks. 
But  I  speak  of  arresting,  or  materially  shorten- 
ing disease.  On  this  point  general  impressions, 
such  general  impressions  as  my  mind  is  capable 
of  receiving,  amount  to  nothing  ;  for  they  are  for 
a  thousand  reasons  most  deceptive  ;  especially 
upon  a  subject  like  this,  where  we  are  pre- 
viously inclined  by  our  hopes,  our  interest,  our 
humanity,  coupled  with  those  of  the  patient  and 
his  friends,  always  to  look  upon  the  bright  side. 
Such  then  must  be  my  mode  of  determining  the 
truth  with  respect  to  any  subject  that  I  investi- 
gate myself.  Look  to  the  history  of  cholera 
through  the  world;  the  successful  remedies, 
almost  as  countless  as  its  victims,  that  have  been 
vaunted ;  the  assured  fronts  and  language  of 
those  who  talk  of  their  hundreds  and  thousands, 
and  none  lost ;  or  yet  worse,  of  the  man  who  had 
one  hundred  patients,  and  saved  one  hundred 
and  three. 

We  live  indeed  in  darkness,  and  it  costs  more 
time  to  discover  the  falsity  of  pretended  truth, 
than  it  would,  perhaps,  to  reach  something  truly 
valuable.  Am  I  wrong  ?  Is  there  any  other  way 
of  establishing  truth  ?  2d.  Here,  my  dear  father, 
is  the  only  second  mode,  in  which  my  mind  (I  do 


FROM    LETTERS.  177 

not  say  my  will,  —  for  it  is  not  an  affair  of  voli- 
tion) will  be  persuaded  ;  i.  e.  that  if  I  do  not  see, 
he,  who  has  seen,  should  write  me  such  an  ac- 
count as  to  prove  that  he  has  investigated  the 
subject  in  the  same  way. 

This  is  to  me  a  ])ainful  subject,  for  I  would 
fain  believe  in  all  the  therapeutics  which  you 
believe  in;  and  yet  the  evidence  that  it  is  true 
must  be  derived  from  your  and  my  general  im- 
pressions. Now,  when  I  have  had  such  ample 
opportunity  to  see  the  futility  of  such  evidence ; 
when  I  hear  men  like  Andral  and  Louis  both 
declare,  that  they  have  been  misled  nine  times 
out  of  ten,  when  they  have  trusted  to  such  evi- 
dence ;  and  that  on  a  minute  examination  of  the 
very  facts,  upon  lohich  and  from  which  these 
general  impressions  have  been  founded  and  de- 
rived, they  have  discovered  their  error ;  when  I 
come  to  examine  English  boolv's,  from  which  we 
receive  the  great  mass  of  evidence  with  respect 
to  therapeutical  success,  and  see  how  they  min- 
gle, even  the  best  of  them,  diseases  vastly  dis- 
tinct in  their  natures  ;  I  ask  myself,  honestly, 
how  far  can  I  trust  all  this  ?  Do  I  believe  that 
bleeding  arrests  inflammation,  as  I  believe  that  a 
certain  combination  of  symptoms  indicates  such 
and  such  a  lesion  ?  Is  not  the  last  proved  by 
12 


178  EXTRACTS 

numerous  demonstrations  ?  Have  I  ever  seen 
one  instance  of  what  the  books  talk  so  easily  of 
as  to  the  first  ?  I  assure  you,  my  dear  father,  in 
the  present  state  of  my  knowledge,  in  my  pres- 
ent view  of  the  existing  state  of  medicine,  I 
believe  that  we  admit  many  things  in  America 
as  axioms,  which  are  very  far  from  being  proved. 
We  have  too  long  believed  that,  because  dem- 
onstration, on  many  points,  was  impossible  in 
medicine,  it  was  not  worth  while  to  study  it  like 
an  exact  science.  It  is  a  very  false  position. 
Just  reflect  for  a  moment  of  what  materials  our 
therapeutic  literature  consists  ;  almost  without 
exception,  chosen  cases  to  prove  the  efhcacy  of 
such  and  such  remedies.  Is  this  the  way  to 
proceed  ?  Suppose  the  chemist  went  to  his 
laboratory  hoping  to  find  oxygen  in  everything, 
and  made  known  to  the  public  those  cases  only 
in  which  he  found  it ;  would  his  science  advance  ? 
What  a  pity  is  it  that  ours  is  a  mixture  of  sci- 
ence and  trade ;  or  what  a  pity,  scientifically 
considered,  that  we  cannot  be  entirely  indifferent 
as  to  results ;  then  we  might  walk  securely. 
But  when  we  are  hoping,  and  our  patients  are 
hoping,  we  are  deceiving  ourselves,  and  often  the 
patients  themselves,  and  us  also.  How  difficult 
is  it  ?  shall  we,  dare  we,  can  we  trust  to  general 


FROM    LETTERS.  179 

impressions  received  from  such  sources,  and  in 
such  a  state  of  mind  ?  If  on  any  subject  rigor- 
ous proof  is  absolutely  necessary,  it  surely  is  to 
establish  a  fact  in  therapeutics.  But  enough ; 
though  when  with  you  I  wish  to  enlarge  more 
upon  this  subject,  and  were  it  not  for  two 
reasons ;  1,  that  I  must  earn  my  bread  ;  2,  that 
I  too  dearly  love  that  world  of  the  affections  to 
which  our  profession  introduces  us ;  I  would 
devote  my  life  to  the  accurate  determination  of 
some  essential  points  of  therapeutics.  Remem- 
ber, I  do  not  deny  the  utility,  in  its  fullest  extent, 
of  all  the  pov/erful  agents  which  I  have  seen  you 
employ ;  —  on  the  contrary,  I  am  inclined  to  be- 
lieve in  them  to  a  certain  extent ;  —  but  my  mind 
(not  my  will)  cannot  receive  the  scanty  evidence, 
which  experience,  lectures,  and  books  have  fur- 
nished as  proof  that  all  is  true. 


Paris,  January  25,  1833. 
^  #  ^  How  sad  is  this  auscultation !    these 
positive  physical  signs  ;  which,  though  in  them- 
selves not  enough,  yet  put  the  seal  of  certitude 
upon  what  before    was    doubtful ;  destroy   the 


180  EXTRACTS 

plausibility  of  many  a  willing  interpretation  of 
other  symptoms  ;  and  leave  us  to  fold  our  hands 
and  await  the  event.  But  it  must  not  be  so. 
It  is  time  that  the  pathological  world  should  turn 
its  attention  to  the  causes ;  those  things  which 
precede  and  lead  to  the  various  organic  diseases, 
and  especially  to  this  one  which  counts  so  many 
victims.  It  is  time  that  we  should  begin  to  col- 
lect those  new  observations,  which  alone  can 
furnish  evidence  upon  this  point;  I  mean  the 
circumstances  of  the  natural  history  of  individ- 
uals.  For  shame  upon  us,  that  the  antiquarian 
can  spend  years  of  toil  and  labor  to  decypher  an 
Egyptian  hieroglyphic,  the  naturalist  a  life  of 
hardships    and  privations    to    ascertain    minute 

■  points  of  no  practical  interest,  and  that  we  should 
pass  our  lives  getting   money,   when,  by  study 

•  and  devotion  to  what  is  intrinsically  of  equal 
interest,  simply  as  an  exercise  of  the  human 
mind,  we  could  reach  such  results  of  essential 
importance  to  the  happiness  of  millions.  I  sug- 
gested this  thing  to  Andral  at  his  house,  a  week 
since.  We  have  learned  to  diagnose  tubercles 
early,  said  I ;  we  can  tell  a  man  that  he  has 
cencer  of  the  stomach ;  but,  that  done,  what 
must  we  add  ?  —  that  a  certain  death  awaits  him, 
and  that  we  can  neither  shorten,  nor  alleviate  it. 


J-HOM   LETTERS.  181 

Is  this  the  end  of  our  studies  ?  Arrived  at  this 
shore,  shall  we  land  and  be  idle  ;  or,  like  honest 
and  enthusiastic  explorers,  shall  we  advance  into 
the  country  and  look  farther  ?  I  added,  the  only 
mode  of  advancing  is  to  have  the  lives  of  a  great 
number  of  individuals  ;  see  under  what  circum- 
stances they  have  lived,  and  what  has  been  their 
end  ;  from  these  premises  we  may  have,  indeed, 
we  must  have  important  conclusions.  He  an- 
swered, "  yes ;  but  men  will  not  do  that."  I 
know  well  that  they  will  not ;  I  know  well  that 
I  have  got  to  be  exposed  to  a  thousand  tempta- 
tions, and  to  nine  hundred  and  ninety-nine,  at 
least,  I  shall  yield.  But  I  pray  God  I  may  have 
strength  to  pursue  this  subject.  There  is  none, 
which  seems  to  me  so  important.  La  verite  est 
dans  les  faits.  On  this  subject,  as  on  every 
other,  facts  properly  collected,  must  lead  to  good« 
My  dear  father,  I  am  very  serious  on  this  point ; 
I  wish  you  would  write  whether  you  sympathise 
with  me  upon  it.  The  question  is  not,  is  it  easy  ? 
Nothing  is  easy  to  do  well.  The  only  question 
iSi  will  it  be  useful  ?  The  only  question  is,  is 
there  any  other  mode  of  arriving  at  the  truth  ? 

Jan.  29.  My  dear  father,  I  have  just  received 
yours  of  December  20th,  and  in  it  there  is  one 
sentiment,  as  to  which  I  most  heartily  agree 
with  you.     You  say,  "  in  spite   of  all  they  say 


182  EiTRACTS 

of  the  wickedness  of  this  world,  you  often  re' 
fleet  how  many  excellent  men  and  women  you 
have  been  acquainted  with  in  this  world. '"^  I 
am  rejoiced  to  read  from  my  dear  father  an  ex- 
pression of  my  own  experience  ;  each  day  I  see 
it  verified ;  and  my  principle  is,  instead  of  al- 
ways acting  upon  the  defensive,  to  be  willing  to 
show  my  colors,  and  make  friends  with  any 
worthy  man.  From  this  circumstance,  my 
friends  are  numerous,  and  I  have  and  do  enjoy 
the  acquaintance  of  many,  who  reward  richly 
one's  confidence  and  sympathy.  ^  =^  =^ 

^  ^  ^  I  have  not  heard  from ,  since  I 

last  wrote  you.  His  wife  was  then  not  very 
well,  but  I  trust  she  is  now  better.  I  love  to 
speak  and  write  of  them.  Each  day  con^  inces 
me  that  the  true  happiness  of  man  consists  in  a 
due  and  active  development  of  his  intellect  and 
affections.  Neither  alone  is  sufficient ;  with  a 
happy  development  of  the  two,  how  much  hap- 
piness is  there  in  this  world, 

*  I  have  printed  the  above  for  the  sake  of  what  fol- 
lows, as  that  throws  light  on  the  character  of  the 
writer.  In  truth,  the  occasion  of  my  remark,  which 
he  has  quoted,  was  my  felicitating  him  on  having 
formed  an  acquaintance,  and,  in  some  cases,  a  friend- 
ship, with  so  many  excellent  people  in  Europe.  I 
remarked  to  him,  that  il  was  an  evidence,  that  this 
world  is  not  so  bad,  as  it  is  often  represented. 


FROM   LETTERS.  1S3 

Paris,  February  6,  1833. 

^  #  ^  Seriously,  my  dear  father,  I  see  that 
my  life  has  got  to  be  in  future  a  little  different 
from  what  my  imagination  loves  to  paint  it.  I 
must  exercise  a  profession  to  get  bread  ;  whereas, 
willing  to  work,  with  a  horror  of  inactive  life,  I 
still  would  love  to  work  solely  to  satisfy  two 
,passions,  a  love  of  science  and  an  exercise  of  the 
affections.  And  yet  I  presume,  the  auri  sacra 
fames  will  touch  me ;  curse  the  day  that  it  com- 
mences-. 


Paris,  April  5,  1833. 

■^  -^  -^  Up  to  the  time  of  Louis  the  same  dis* 
tinction  had  not  been  made,  as  now,  between  an 
acute  disease,  in  a  previously  healthy  subject, 
and  in  one  who  was  already  diseased.  The  pa- 
thological laws,  which  reign  over  the  acute  dis- 
ease in  these  two  instances,  are  very  different 
however.  Again,  I  mean  previous  to  the  light 
which  Louis  has  thrown  upon  our  science,  the 
force  and  beauty  of  which  I  feel  daily  more  and 
more,  attention  was  not  paidtoaZZ  the  functions 
during  life   and  all  the  organs   after  death ;  at 


184  EXTRACTS 

least  by  the  French  and  English  authors  who 
have  written  ;  for  it  is  with  pride  and  delight 
that  I  each  day  repeat  to  myself,  "  Yes,  my  fa- 
ther examined  in  every  disease,  all  the  functions  ;'* 
he  felt  the  importance  of  knowing  the  state  of 
all,  in  each  disease  ;  of  each  of  them.  But  did 
he  examine  all  the  organs  after  death  ?  No  ; 
this  is  peculiar  to  Louis.  He  can  tell  yon  in 
each  disease  not  only  the  lesions  of  the  organ 
originally  affected  ;  but  also  the  proportion  of  the 
secondary  lesions,  which  follow  each  disease. 
This  is  perhaps  one  of  thegi'eatest  services,  which 
my  French  master  has  rendered  to  science  ;  and 
as  I  begun,  so  I  finish,  from  an  inattention  to  it, 
as  well  as  to  some  other  essential  points,  many 
of  the  observations  of  the  best  authors  lose  one 
half  their  value.  May  I  give  you  a  single  ex- 
ample of  the  beautiful  results,  to  which  Louis 
has  arrived  by  this  scrupulous  examination  of  all 
the  organs  in  every  disease  ?  Variola,  —  which, 
thank  God,  I  shall  not  see  at  home  as  I  have 
here,  —  what  is  the  usual  cause  of  death  in  this 
disease  when  it  proves  fatal  ?  Authors  talk  of 
the  exhausted  system,  inflammation  of  alimentary 
canal,  inflammation  of  the  brain,  &c.  —  all  this 
is  nonsense  ;  for  it  cannot  be  proved.     But  what 


FROM    LETTERS. 


185 


tas  Louis  found  to  be  the  cause  of  death  ? 
While  at  la  Charite  (six  years  since)  of  twenty 
cases,  sixteen  died  of  laryngitis  ;  false  membrane 
lining  the  larynx;  swelling,  &c.  of  mucous 
membrane ;  great  diminution  of  calibre  of  glot- 
tis. This  he  has  seen  confirmed  at  least  as  many 
times  more ;  as  I  have  also  six  or  eight  times  at 
la  Pitie.  Well,  why  was  not  this  essential  and 
all-important  lesion  known  before  ?  simply  be- 
cause pathologists  did  not  open  the  larynx  of 
variolous  subjects.  They  were,  in  respect  to  this 
point,  in  the  same  condition  as  the  ancients  with 
respect  to  morbid  anatomy  in  general. 

I  choose  this  example  because  it  is  striking ', 
but  both  of  my  beloved  master's  works^  are  full 
of  similar  ones. 


Paris,  June  6,  1833. 

#  ^  #  I  must  not  forget  to  tell  you  that  I 
have  this  moment  seen  a  new  case  of  Bright's 
kidney,    the    second   which    Andral  has    found 

*  The    reference    here    is    to  Louis  on  phtliisis    and 
on  typhus. 


186  EXTRACTS 

since  I  showed  him  mine.  But  what  especially 
fills  my  mind  at  this  moment  is  the  most  superb 
case  of  pneumonia  I  ever  saw,  now  in  our  ward. 
Superb !  why  ?  from  its  therapeutic  interest. 
How  delicious  is  it,  among  the  mass  of  dying 
and  dead,  when  the  only  occupation  is  to  describe 
the  phenomena  during  and  after  life,  and  now 
and  then  to  palliate  ;  how  delicious  it  is  I  say, 
to  see  here  and  there  a  severe  case  of  acute  dis' 
ease,  dangerous  from  its  nature,  arrested ;  its 
duration  reduced  from  twenty  to  four,  or  five 
days.  Listen.  A  man  ast.  36,  on  the  night  of 
the  3d  of  this  month,  at  eleven  P.  M.  was  aroused 
suddenly  from  his  sleep  by  severe  pain  in  left 
side;  to  which  were  added  oppression,  cough, 
and  pneumonitic  expectoration.  He  w^as  per- 
fectly well  when  he  went  to  bed,  worked,  &c.  as 
usual  during  the  day.  No  more  sleep  that  night ; 
increase  of  symptoms  with  heat,  anorexy,  thirst, 
&c.  Entered  hospital  in  state  of  extreme  dys- 
pnoea, &c.  at  nine,  A.  M^  next  day :  then 
bronchial  respiration  over  the  middle  third 
of  left  chest  behind,  with  a  little  crepitous 
rale  and  bronchophony.  (Hepatization  of  large 
portion  of  left  lung  already  at  tenth  hour  of  the 
disease).  Bled  to  twenty  ounces,  when  he 
fainted.     I  saw  him  again   at    two,  P.  M.     Tiie 


FROM   LETTERS. 


ist 


crepitious  rale  had  disappeared,  —  nothing  but 
bronchial  respiration.     Respiration,  thirty-six  a 
minute ;   (I  forgot  to  mention  flatness  on  percus- 
sion over  same  space  ;)  still  much  fever,  anxiety, 
pain,  dyspnoea,  although  great  relief  since  morn- 
ing.    Next  morning,    the  5th,   same    condition, 
except  that  the  general  symptoms,   as   also  the 
rational  symptoms,  had  decreased  in  intensity, 
whereas  the  bronchial  respiration  was  still  more 
distinct ;  as   yet   no  return   of   crepitous    rale. 
Venesection  to  fifteen  ounces.     In  evening  at  six 
o'clock  great  relief  expressed  by  patient  as  to  all 
symptoms.     Respiration  twenty-two   instead  of 
thirty-six,  as  last  evening  ;  —  bronchial  respira- 
tion almost  disappeared,  and    its  place   supplied 
by  the  returning  crepitous  rale,  wdth  some  vesi- 
cular  expansion,  although    still  a   little   of  the 
bronchial  character  ;  —  flatness  less.    This  morn- 
ing, 6th,  the  man  expresses  a  state  of  "  perfectly 
well ;"  says   he  can  turn   in   every    direction  ; 
in   spite   of  thirty-five   ounces  of  blood  lost,  is 
infinitely   stronger    than    at    entrance;  —  pulse 
seventy-six,  instead  of  one  hundred  :  respiration 
twenty-two,  instead  of  thirty-six ;  no  pain,  nor 
other  symptoms ;  asks   for  food  ;  vesicular    ex- 
pansion abundant  at  the   left,  behind,  with  crep- 
itous rale  and  scarcely  any  bronchial  respiration. 


188 


EXTRACTS 


The  man  is  nearly  convalescent,  and  here  wd 
are  at  the  fifty-fifth  hour  of  a  ^rave  pneumonia, 
which  occupied  the  two  inferior  thirds  of  the 
left  lung  behind,  which  began  severely,  which 
had  already  reached  hepatization  at  its  tenth 
hour,  which  was  attended  with  such  severe 
symptoms  as  to  make  patient  enter  at  that  early 
hour.  My  dear  father,  I  rub  my  hands  with 
joy.  I  hope  for  treatment  during  the  first  hours. 
I  say  hope  ;  for  although  I  may  safely  say  I  have 
passed  one  quarter  of  the  hours  of  daylight, 
indeed  half,  in  the  wards  of  la  Pitie  for  six 
months,  and  although  this  is  No.  21,  of  my 
cases  of  pure  pneumonia,  which  I  have  collected 
in  the  greatest  detail  there,  still  it  is  also  the  first 
that  I  have  seen  apparently  controlled  by  vene- 
section ;  —  the  first  bled  under  less  than  twenty 
four  hours.  I  have  no  time  to  write  another 
sheet,  and  ought  almost  to  beg  pardon  for  filling 
this  with  so  rapid  and  abridged  a  history  to  an 
American  physician,  to  whom  such  cases  are  not 
rare. 


FROM   LETTERS.  189 

Paris,  June  27,  1833. 
%  ^  #  J  received  your  letters  of  the  13ih  and 
21st  ult.,  three  nights  since,  together.  They 
cost  me  thirty  drops  of  laudanum,  for  my  heart 
beat  so  hard  and  my  head  worked  so  fast,  in  con- 
sequence of  the  thoughts,  speculations,  castle 
building,  &c.  to  which  they  gave  rise,  that  I 
could  not  sleep,  and  knowing  I  must  be  up  at  six, 
A.  M.  I  could  not  afford  to  play  the  dreamer  with 
my  eyes  open,  all  night.  So  you  consent  to  my 
observing  a  certain  number  of  years,  if  I  see  fit, 
after  a  due  consideration  of  the  matter,  and  you 
advise  me  not  to  decide  until  upon  the  scene  of 
my  future  life  I  may  better  know,  weigh  and 
appreciate  the  circumstances  w'hich  should  gov- 
ern me.  My  dear  father,  I  thank  you  equally 
for  the  permission  and  the  advice,  and  promise 
as  implicitly  to  follow  the  one  as  I  gratefully 
accept  the  other.  I  know  well,  there  are  a  thou- 
sand circumstances  to  consider  relative  to  this 
subject ;  perhaps  some  occur  to  me  which  strike 
you  with  less  force  :  perhaps  my  life  here  and 
my  experience  of  the  men  in  the  first  places  may 
have  given  me  certain  hopes,  and  at  the  same 
time  certain  horrors,  which  you  do  not  realize  so 
strongly  as  I  do.  I  say  perhaps,  and  perhaps 
only ;  —  for  you  are  so  apt  to  look  at  every  side 


190  EXTRACTS 

of  a  question,  that  I  dare  hardly  presume.  Cer- 
tainly on  the  other  hand,  certainLij  you  will  pre- 
sent to  my  mind  views  of  the  subject,  which  I 
neither  see  nor  feel ;  and  it  would  be  only  to 
continue  in  the  sad  way  I  have  always  followed 
to  listen  too  little  to  the  wisdom  and  kindness  of 
the  best  of  fathers,  did  I  allow  myself  to  decide 
on  any  important  point  of  life  without  his  aid 
and  instruction.  Be  assured  then,  my  dear 
father,  that  my  mind  shall  be  kept  open  to  con- 
idction.  I  ask  only  that,  once  there,  you  shall 
endeavor  to  keep  my  mind  in  a  right  state,  and 
not  let  the  judgment  be  biassed  by  desires  and 
temptations,  laudable  in  themselves,  but  baneful 
to  him  who  would  for  a  while  make  science  his 
sole  mistress.  The  more  I  advance  in  life  the 
more  I  see  and  feel  convinced  that  its  great  and 
chief  happiness  is  self-education ;  self-develop- 
ment, intellectual  and  moral.  God  knows  I  have 
enough  of  both  to  do.  May  I  only  be  industri- 
ous at  the  work  !  I  tremble  when  I  reflect  upon 
the  number  of  subjects  as  yet  unknown,  but 
which  must  be  known  to  me. 


FROM    LETTERS.  191 

The  two  letters  which  follow,  were  addressed 
to  a  medical  friend,  who  kindly  sent  them  to  me. 
The  playful  style  of  controversy  will  be  readily 
understood  from  the  extracts  here  printed ;  though 
it  would  be  more  so,  if  the  letters  were  given 
entire.  I  have,  how^ever,  erased  all  personal 
allusions.  I  trust  that  the  letters  will  not  be 
thought  devoid  of  interest.  J.  J. 


Paris,  December  9,  1833. 
MY    DEAR    DOCTOR,  

If  you  w^ill  deign  to  receive  a  word  from  a 
poor  youth,  who  strives  to  estimate  morbid  anat- 
omy at  its  true  value,  placing  it  neither  above 
nor  below  its  proper  rank,  he  will  be  happy  to 
say  a  word  in  self-defence.  But,  first,  let  me 
thank  you  for  your  kindness  in  writing  me  such 
a  good  long  letter,  full  of  pleasant  Avords  and 
kind  rebukes  and  w^holesome  counsel. 

I  am  glad  that  you  are  not  displeased  with  my 
Utile  memoir  upon  cholera.  I  grieve  that  you 
misunderstand  me  upon  some  points,  and  that 
we  cannot  agree  upon  a  few  others. 

1st.  You  misunderstand   extremely  my  esti- 


192  EXTRACTS 

mation  of  morbid  anatomy.     I  see  I  must  make 
a   rapid  confession   of  faith  in  order  to  let  you 
see  in  what  light  I  consider  this    science.     1.  I 
conceive  it  to  be  OTie  of  the  modes  by  which  we 
are  to  obtain  a  knowledge   of  the  phenomena  of 
disease,  —  but  by  no  means  the  only  one.     2.  I 
conceive  and  know  that  in  some  cases  it  affords 
very    important  positive   knowledge    as    to   the 
nature  of  disease.     3.  I  am  equally  aware  that 
in  many  cases   it  affords  negative  information 
only.      But    this    ?iegative    information    is    as 
important,   perhaps,   as    the   positive.     It  is  as 
useful  to  know  that  a  thing  is  not  as  that  it  is : 
each  is  a  truth  in  nature :  each  enters  equally, 
as  an  element,  into  science  :  to  omit  either,  is  to 
be   guilty   of   an  equal    omission.     4.   Besides 
those  cases,  in  which  morbid  anatomy  teaches  us 
nothing  positive,  are  yet  many  others,  in  which, 
although  from   it  we  may  gain  positive   know- 
ledge, we  are  still  sure  that  something  more  has 
existed,  and  has  influenced  the    organs  and  the 
economy  during  life.     5.  Indeed,  in  all  cases  of 
disease,    there   is   ever  an  unknown  something 
which  morbid  anatomy  can  7iever  teach  us :  viz. 
that  state,  or  condition  of  the  parts,  which  pre- 
cedes, and  is  the  immediate  cause  of,  the    mor- 
bid process  ;  and   which  we  know  must   exist, 
though  we  can  neither  see  nor  feel  it.   En  resume, 


FROM    LETTERS.  193 

then,  I  esteem  morbid  anatomy  as  always  afford- 
ing evidence,  either  positive  or  negative,  which 
must  be  taken  into  the  account  by  every  rational 
pathologist ;  but,  on  the  other  hand,  there  lives 
not  the  man,  who  is  more  firmly  persuaded  than 
myself  of  its  insufficiency  to  afford  us  an  answer 
to  all  that  we  must  look  for  in  this  dark  science 
of  pathology.     It  is  but  last  w^eek  that  I  wrote 
my  father  very  much  in  these  words :  "  If  my 
life  in  Paris  has  enabled  me  to  appreciate,  much 
more  fully  than  before,  the  advantages  of  morbid 
anatomy,  my  mind  has  not  been  the  less  struck 
with  this  all  important  truth,  that  morbid  anatomy 
is  very  far  from  sufficient  to  satisfy  all  the  desid- 
erata of  the  pathologist."     I  take  the  trouble  to 
go  a  little  into  detail  here,  because  I  regard  the 
man,  who  esteems  this  science  as  the  "  fons  et 
origo,"  and  the  only  true  one,  of  important  and 
well  established  truth  in  pathology,  I  regard  such 
a  man,  I  say,  as  taking  a  very  limited  view  of 
this  science,  and  as  being  very  deficient  in  his 
mode  of  pursuing  it.     I  am  unwilling  that  you 
should  regard  me  as  such. 

But  although  you  will  be  pleased  with   this 

avowal,  you  will  ask  me,  what  other  evidence  I 

am  willing  to  admit  in  order  to  decide  the  nature 

of  disease.     I  am  ready   to   answer,  two  other 

13 


194  EXTRACTS 

modes  of  evidence  are  admissible ;  but  both  arc 
to  be  used  with  extreme  caution,  most  especially 
the  last.     1.  The  symptoms;  —  these  it  is  evi- 
dent, will  be  variously  esteemed  according  to  the 
Y3iTying physiological  views  of  the  observer.     The 
ground,  then,  is  dangerous  ;  for  there  are  theo- 
ries upon  the  animal  economy,  so  mechanical,  so 
chemical,   so    wanting    in   beauty,   leading    so 
little  to  the  delightful   views  of  God  and  his 
power,  which  certain  others  do  inspire  us  with, 
that  I  thank  God,  my  mind  is  made  to  admit  the 
last  rather  than  the  first.     It  must  be  allowed 
that  the  evidence  afforded   of  the  nature  of  a 
disease,  by  the  symptoms  of  that  disease,  is  to  be 
adopted  with  great  circumspection.     I  could  cite 
examples  of  an  abuse  of  this  species  of  evidence ; 
but  to  you  this  is  useless.  2.  Analogy ;  how  much 
may  we  trust  to  analogy  ?  I  doubt  not  it  is  useful. 
Each  day  I  employ  it ;  indeed  without  it  I  could 
scarcely  live.     But   I  fear  it  greatly;  I   know 
how  liable  it  is  to  abuse. 

And,  now,  my  dear  doctor,  that  I  have  spent 
half  a  sheet  upon  this  subject,  I  will  begin 
another  to  answer  your  second  complaint  against 
your  humble  servant.  A  few  words  will  suf- 
fice. 

2d.  You  abuse  me  because  I  will  not  geTieral- 


FROM    LETTERS.  195 

ize  :  in  other  words,  because  I  will  not  adopt,  as 
my  sworn  creed,  those  opinions  which  originated 
with  your  ever  to  be  respected  friend  and  master, 
and  which  have  been  confirmed  and  strengthened 
by  your  own  laborious  observation  and  research. 
In  the  first  place,  I  know  that  you  would  despise 
me  more  than  any  other  could,  did  I  pretend, 
through  a  desire  in  every  respect  to  coincide 
with  a  man  to  w^hom  both  my  reason  and  my 
affections  have  so  much  attached  me,  to  adopt 
all  his  opinions,  when  I  was  not  satisfied  that 
they  w^ere  true.  I  do  not  yet  know  the  facts. 
I  am  by  no  means  in  a  condition  to  decide  the 
question,  whether  fever  be  only  a  local  or  a  gen- 
eral disease ;  and,  if  either,  whether  it  has 
always  one  seat,  or  always  consists  in  the  same 
phenomena.  Instead  of  not  generalizing  enough, 
I  have  done  so  too  much ;  many  questions  are 
now  doubtful  in  my  mind,  to  which  I  w^as  in- 
clined to  give  a  very  positive  answer  before  I 
came  to  Europe.  And  why  have  they  become 
doubtful  ?  Simply  because  I  have  learned  facts 
which  I  did  not,  then,  know  ;  and  I  think  it  wise 
to  wait  till  I  have  become  yet  better  acquainted 
with  them,  and  to  search  for  others,  before  I  form 
any  general  opinions  upon  some  most  important 


196  EXTRACTS 

subjects.  Instead  of  being  in  a  hurry,  I  sincerely 
hope  that  I  shall  yet  wait  ten  years  or  more  :  and 
above  all,  I  trust  I  shall  always  be  of  my  present 
mind  upon  one  point,  viz  :  to  prefer  to  acknow- 
ledge myself  in  doubt,  where  the  nature  of  the 
subject  necessarily  renders  it  doubtful,  than  to 
attach  myself  to  any  opinion,  the  truth  of  which 
I  know  to  be  very  far  from  demonstrable.  My 
mind  is  so  constituted  that  I  enjoy  more  to  say, 
"  well,  this  point  is  unsettled ',  there  are  such 
arguments  or  such  facts  for  one  view,  and  again 
such  others  for  the  other ;  we  cannot  yet  decide  ;" 
than  to  cry  with  the  ardent  and  restless  theorist, 
"  I  know  that  there  is  a  certain  degree  of  doubt ^ 
but  I  mill  believe,  for  on  the  whole  it  seems  to 
me  true."  It  may  be  politic,  or  even  useful  at 
times  to  suppress  the  little  doubts,  which  arise 
against  what  we  regard  as  important  truth,  which 
is  to  affect  the  public ;  —  as  we  may  say  nothing 
about  our  fears  of  the  possible  ill  effects  of  a 
bold  course  of  medical  treatment,  which  we 
think  on  the  whole  useful ;  and  yet,  as  scientific 
men,  in  both  cases,  it  would  be  the  height  of  folly 
for  us  not  to  distinguish  hQiwQen probable  and  cer' 
tain,  demonstrated  truth.  I  apply  this  to  myself, 
the  student,  who  am  not  yet  sufficiently  advanced 
in   my  knowledge   of  facts  to  form  an  opinion 


PROM   LETTERS.  197 

upon  certain  subjects.  There  are  several  in 
which  my  father  has  and  I  had  implicit  belief, 
but  which  now  I  doubt :  he  knoios  them  to  be 
true  ;  I  do  not.  It  is  the  same  with  you  ;  you 
have  studied  your  subject,  long,  fully,  in  all  its 
details ;  you  have  arrived  at  an  opinion  ;  but 
tliat  does  not  necessarily  make  me  a  subscriber 
to  it ;  because  you  are  learned,  it  does  not  make 
me  the  less  a  mere  learner  ;  because  you  have 
run  the  course  and  attained  your  end,  and  exam- 
ined closely  your  object,  and  thus  fixed  firmly 
your  opinion,  it  does  not  prove  that  I  am  not 
simply  on  the  road,  as  yet  unacquainted  with 
much  that  you  are  familiar  with.  In  other 
words,  because  you,  from  your  abundance  or 
knowledge,  have  a  right  to  generalize,  I,  in  the 
depth  of  my  ignorance,  have  no  such  right.  I 
might  possibly  have  taken  the  liberty  of  trying 
to  prove  to  you  that  you  generalize  too  soon,  as 
you  have  accused  me  of  the  contrary  extreme ; 
but  I  fear  your  heavy  cannon,  and  I  ^\^^,  there- 
fore, be  silent,  preferring  to  answer  by  the  defen- 
sive, instead  of  answering  your  question  with 
another,  as  the  robber  says  to  Alexander,  or 
Alexander  to  the  robber  in  one  of  my  school 
days'  dialogues,  for  I  forget  which. 


198  EXTRACTS 

Paris,  June  18,  1833. 
MY    DEAR    DOCTOR,  

We  had  yesterday  the  pleasure  of  seeing  your 
friend  A.  ;  and,  aUhough  our  interest  with  the 
Northern  Courts  is  not  so  immense  as  your 
words  would  seem  to  imply,  we  shall  endeavor 
to  render  what  little  services  are  in  our  power  to 
Mr  A.,  whom  I  see  to  be  a  good  fellow,  because 
he  seems  duly  to  appreciate  your  character.  =^  ^  =* 

Do  you  mean  to  overwhelm  me  with  ridicule  ? 
When  I  have  chosen  my  science,  and  you 
yours,  do  you  think  it  just  to  take  it  for  granted 
that,  because  the  one  is  eminently  calculated  to 
develope  the  mind's  best  powers  and  the  soul's 
best  affections,  the  other  cannot  and  is  not  equally 
so  ?  As  a  scientific  man,  you  must  surely  forget 
yourself,  when  you  attempt  to  prove  that  botany, 
or  geology,  or  any  other  of  the  sciences,  as  a 
science,  is  better  calculated  to  improve  the  intel- 
lect, or  to  afford  pleasure  to  the  student,  than  is 
medicine ;  or,  rather,  the  accessory  sciences 
which  compose  it.  What  is  the  pleasure,  what 
the  occupation  of  a  truly  scientific  man  ?  Surely, 
from  an  exact  and  detailed  observation  of  what 
his  senses  can  demonstrate  to  him,  upon  a  given 
subject,  to  trace  the  great  general  laws  of  nature 
upon  that  subject.     This  I  maintain    to   be   the 


FROM    LETTERS. 


199 


fundamental  attraction  of  every  science,   to   one 
who  will  view  the  subject  as   a   man  of  science 
should.     This  being  taken  for    granted,  and  I 
think  you  will  hardly  deny   it  me,  I  would  beg 
you  to  point  out  the  real  distinction,  scientifically 
spealdng,  between  tracing  the  pollen  tubes  to  the 
ovula  of  an  asclepias,   with  the  eye,  and  follow- 
'  inff  with  the  ear   the    various   modifications  of 
sound  produced  in  the   chest  by  a  pneumonia. 
Why   with  my   telescope,  may  I  not  as   much 
enjoy  a  crepitous   rale,    (of  the  first  order,)  or  a 
bronchial  respiration  of  the  purest  tone,  as  Brown, 
with  his  microscope,  a  little  channel  leading  from 
one  part  to  another  of  his  flower.     In  both  cases 
what  do  we  do  ?     Appreciate,  by  the  nice  use  of 
our  senses,  the  phenomena  appreciable  by  them, 
and  then  from  these  phenomena,  connected  with 
our  previous  knowledge,  arrive  at  some   law  of 
the  exis^tence  of  these  two  beings;    an  asclepias 
on  the  one  hand,  a  pneumonia  upon   the   other. 
Perhaps  I  deceive   myself ;  but  I  think  not ;  if 
any  distinction  exists  between  these  two  things, 
point  it  out   I  pray   of  you.     The  reason   that 
medicine,  (or,  to  use  a  better  term,    the    reason 
that  pathology  and  therapeutics,  or   the    natural 
history  of  disease  before  and  after  death,  and  the 
influence  of  external  agents  upon  the  march  of  dis- 


200  EXTRACTS 

ease,)  is  so  despised  as  a  science,  is,  that  it  has 
never  yet  been  studied  as  a  science.  But  the  time 
has  come  ;  it  actually  now  takes  rank  with  the 
other  sciences ;  only  it  is  the  least  advanced  of 
them. 

We  have  learned  that  ^o^zYii^e  knowledge  may 
be  gained,  where  we  formerly  admitted  the  most 
loose  assertions  of  each  popular  author,  as  he 
came  along.  Studied  as  a  science,  I  maintain 
that  it  has  as  strong  a  claim  as  any  other,  upon 
the  best  heads ;  and  upon  any  one,  whose  object 
is  to  develope  to  the  utmost  his  intellectual  pow- 
ers. Why,  then,  abuse  me  for  studying  it  ? 
Should  I  make  duty  my  guide  ?  My  duty  is  to 
prepare  myself,  as  well  as  lies  in  my  power,  upon 
this  obscure  and  difficult  subject,  which  is  to  be 
the  practical  subject  of  my  life.  Is  it  enough 
for  me  to  know  what  the  books  can  teach  me  ? 
They  contain  more  falsehood  than  truth  ;  and  I 
cannot  distinguish  between  them  without  study- 
ing nature.  My  duty,  then,  reduces  me  to  the 
necessity  of  observing  nature  in  her  diseased 
operations  in  the  human  economy.  But  how 
much  time  shall  I  give  to  it  ?  As  much  as  possi- 
ble, is  the  only  answer  ;  because  even  that  will 
not  suffice.  Again,  shall  we  leave  duty  to  those 
who  follow  its  dictates  more  than  myself;  shall 


FROM    LETTERS.  201 

I  ask  of  taste,  shall  I  take  pleasure  for  my  guide  ? 
Same  answer;  my  education  and  habits  of  life 
have  so  constituted  me,  that  it  is  my  greatest 
pleasure  to  pursue  disease  in  its  myriad  wan- 
derings. It  is  :  I  do  not  say  it  ivill  be.  Since, 
then  duty  and  pleasure  lead  me  to  one  object, 
why  should  I  turn  my  back  upon  it  ?  But  again, 
frankly  I  will  acknowledge  one  thing,  viz.  that  in 
my  castle  building  for  future  life,  I  sometimes 
tremble  ;  and  your  sentence,  of  "  pity  poor  Jack- 
son's wife,"  has  made  me  tremble  anew.  To 
effect  what  I  propose  to  myself,  and  what  I  truly 
think  v\'-ill  be  the  best  possible  use  of  my  means 
and  time,  will  occupy  me  most  intensely  for 
years.  I  do  not  mean  that  I  shall  not  have  min- 
utes at  my  disposal  and  hours  too ;  but  that,  in 
all  the  best  and  brightest  of  those  minutes,  when 
my  mind  is  truly  awake,  it  will  inevitably  recur 
to  the  subjects  of  my  study.  All  this  need  not 
be  ;  I  can  put  bounds  to  what  I  propose.  I  can, 
from  the  moment  I  reach  home,  devote  but  a 
given  time  to   the  objects  of  science.     But,  my 

dear ,  as  a  kind   friend,   you    should  look, 

with  a  little  of  your  heart's  as  well  as  your 
mind's  eye,  upon  my  situation.  You  should 
reflect  upon  my  father,  what  he  is,  and  where  he 
is,  and  what  will  be  his  disappointment  if  I  fall 


202  EXTRACTS 

short  in  the  race.  It  must,  then,  be  my  object 
so  to  follow  my  studies,  as  best  to  secure  what 
he  desires  and  depends  upon.  Upon  this  point? 
I  believe,  honestly,  that  I  am  better  able  to  judge, 
than  either  yourself,  or  he.  I  believe  so,  because, 
pursuing  the  science  later  than  either  of  you,  I 
know  and  feel  more  deeply  what  is  to  be  its 
march  for  the  next  half  century.  I  know  how 
it  will  be  followed  by  those,  who  are  to  rank  as 
masters.  But,  again,  if  pleasure,  happiness,  be 
the  only  end  of  life,  I  do  not  agree  with  you  as 
to  the  means  of  gaining  it.  I  do  not  here  refer 
to  any  difference  as  to  the  estimation  of  domes- 
tic enjoyments  ;  I  always  appreciated  them  most 
highly.  I  refer  to  science  as  a  source  of  happi- 
ness. In  what  way  should  a  man  cultivate  it, 
so  as  to  obtain  the  greatest  possible  individiial 
pleasure  from  it  ?  Should  he  be  superficially 
acquainted  with  several  branches  of  science, 
reading  what  others  have  observed,  or,  perhaps, 
observing  in  general  what  others  have  pointed 
out  in  detail ;  or  should  he  be  one  of  those, 
who  himself  observes  and  describes  for  others  '? 
In  other  words,  is  the  happiness,  which  may  be 
derived  from  the  contemplation  of  the  laios  dis- 
covered by  others,  to  be  compared  with  that, 
experienced  by  him  who  discovers  them  ?     Is  a 


FROM    LETTERS.  203 

knowledge  of  generals,  which,  after  all,  a  man 
who  knows  not  the  details  intimately,  must  re- 
ceive partly  on  trust,  —  is  that  knowledge,  I  ask, 
productive  of  the  same  pleasurable  emotions,  as 
a  knowledge  of  details ;  of  those  details  upon 
which  the  generals  are  founded  ?  We  all  admire 
the  beautiful  laws  of  gravity,  of  electricity,  of 
chemistry.  But  have  w^e  ever  experienced  a 
millionth  part  of  the  elevation  ("  exaltation")  of 
Newton,  or  Franklin,  or  Davy  ?  Surely  not. 
The  same  is  true  upon  a  smaller  scale.  I  am 
much  happier  in  pursuing  my  science  in  a  strictly 
scientific  manner,  i.  e.  by  an  actual  observa- 
tion of  all  diseased  phenomena  by  my  own 
senses,  than  if  I  read  for  years  the  results  of  the 
labors  of  Cuvierand  Brown,  and  Decandolle,  &c. 
&c.  Really,  to  study  any  science,  with  the 
hopes  of  at  all  advancing  it,  requires  all  one's 
time,  and  all  his  mind  ;  but,  if  he  loves  that  sci* 
ence,  he  will  be  repaid  by  what  he  discovers. 


REMINISCENCES 


or 


JAMES     JACKSON,    Jr. 


BY    A    FELLOW    STUDENT. 


REMINISCENCES. 


James  Jackson,  Jr.  was  my  school-mate  at  the  Pub- 
lic Latin  School  in  Boston,  my  class-mate  at  Harvard 
University,  ray  fellow-student  in  medicine  while  in  Bos- 
ton and  in  Paris,  and  I  spoke  to  him  often  duiing  many 
years,  but  I  never  knew  him  until  we  met  in  Europe.    I 
shall  now  speak  of  him  as  I  saw  him  there.     He  was  in 
England  when  I  arrived  at  Paris,  and  I  did  not  meet  him 
until  four  months  had  elapsed.     During   the   following 
winter  we  were  together  every  day.     As  his  connexion 
with  Louis  had  perhaps  greater  influence  upon  his  cha- 
racter than  almost  any  other  circumstance  he  met  with 
abroad,  it  may  not  be  uninteresting  to  trace  the  connex- 
ion between  them  in  its  origin,  its  progress  and  its  termi- 
nation.    Jackson  arrived  in  Paris  in  the  spring  of  1831. 
He  had  read  of  and  heard  of  Louis,  and  had  formed  a 
very  high  opinion  of  him,  but  he  learned   to  respect 
him  much  more  after  he  became  acquainted  with  the 
powers  possessed  by  that  great  pathologist.     He  heard 
his  clinical  lectures  during  the  winter   of  1831-2,  and 
for  three  months  previously  had  attended  his   clinical 
visits   occasionally,   without  becoming   personally  ac- 
quainted with  the  professor.     He  was  not  aware  that  the 
latter  had  noticed  him,  until  one  day  a  friend  told  him 


208  REMINISCENCES. 

that  Louis  had  asked  wlio  he  was,  in  these  words, 
"  What  is  the  name  of  the  young  American,  who  at- 
tends my  visits  —  I  mean  that  one  who  discovers  every- 
thing which  I  do  when  auscultating  our  patients?  I 
sfiould  be  pleased  to  know  him,  for  he  has  a  fine  mind." 
About  tliis  same  time  also,  Jackson  was  one  day  stand- 
ing at  the  foot  of  the  bed  of  a  patient  affected  with  some 
pulmonary  disease,  and  Louis,  after  having  examined 
liitnself,  requested  several  who  stood  by  to  do  so,  and 
make  their  report  to  him.  After  they  had  returned  un- 
satisfactory answers,  he  looked  towards  my  friend,  and 
told  him  to  come,  for,  says  he,  you  are  "  great  in  aus 
cultation."  Jackson  mentioned  this  fact  and  said  the 
deep  pleasure  he  experienced  at  that  moment,  almost 
took  from  him  the  power  of  examination. 

He  became  afterwards  more  acquainted,  and  used  to 
walk  occasionally  with  his  preceptor.  At  length,  he  with 
two  other  Americans  asked  him  to  give  them  private 
instruction  in  auscultation  and  percussion.  This  made 
them  quite  intimate,  and  his  love  and  respect  increased 
daily,  though  still  he  felt  always  a  kind  of  reverence, 
which  kept  him  at  a  distance  (as  he  told  me)  from  the 
professor,  until  after  his  return  from  England,  in  the 
autumn  of  1832.  Jackson  often  mentioned  to  me  the 
great  pleasure  he  experienced  at  the  reception  he  met 
with  from  Louis  on  his  return.  He  arrived  and  imme- 
diately went  to  the  hospital,  where  the  professor  was 
then  engaged  in  making  his  visit.  To  use  the  words  of 
Jackson  —  "he  came  from  the  patient  lie  was  examin- 
ing, shook  hands  with  me,  and  said  he  was  glad  to  see 
me  again ;  and  when  we  came  out  the  hospital,  he  put 
liis  arm  within  mine  and  we  walked  home  together." 


OF    JAMES    JACKSON,  JR.  209 

From  tliis  moment,  Louis  and  Jackson  were  near  friends. 
Scarcely  ever  did  a  day  pass  that  they  did  not  leave 
the  hospital  together.     It  was  quite  curious  to  the  stu- 
dent of  human    nature,  to  mark   the  peculiar  feelings 
which  existed  between  them.      It  was  a  mingling  of 
parental  and  filial  tenderness,  with    those  friendly  feel- 
ings that  may  spring  up  between  equals  in    age,  from 
respect  for  each  other's  talents   and  hearts.     They   had 
much   influence    over   each   other.      Louis    persuaded 
Jackson    to  give  up    his   intended    visit    to    Germany. 
Jackson    would,  by   his   ingenuousness,  lead  Louis  to 
lay  before  him   the    whole  feelings    of  his  heart.     His 
young  zeal,  guided  as   it  was  by  a  philosophical  mind 
and  pure  heart,  served  to  animate  even  his  master. 

Louis,  I  have  said,  had  much  influence  upon  Jackson 
in    exciting   him  to  continued  ardor  in  his   profession, 
and  as  member  of  the  Society  for  Medical  Observation, 
of  which    he  had  become  one  of  the  original  associates 
at  the  special  request  of  Louis.     This  society,  of  which 
my  friend  was  a   most   active  member,  is  composed  of 
young  physicians  in  attendance  upon  the  Paris  hospitals 
and  of  Louis  who  is  President  for  life.     The   object  of 
the  society  is  to  make  good  and  careful  observers  of  the 
phenomena  of  disease,  and  by  their  united  exertions  they 
hope  to  benefit  the  cause  of  medicine.     They  hold  their 
meetings  every  Saturday  evening.     One  or  two  cases 
or  observations  are  read  and  placed  in  the  archives  of 
the  Society.     After   a  case  has   been  read,  each  mem. 
ber  has  a  right  to  criticise  it;  and  generally  the    rod   is 
applied  with   great  severity   and   yet   all  is    harmony. 
Every  individual  is  supposed  to   be   a  more  ardent  ad- 
mirer of  truth  than  of  his  own   works.     Consequently, 
each  takes  his   brother's  remarks   with   kind  feelings. 
]4 


210  REMINISCENCES 

Jackson  did  much  wood  to  the  Society  by  the  many 
observations  he  presented  to  it,  and  by  his  criticisms 
upon  those  of  otiiers.  He  seemed  quite  to  forgot  that 
Jie  was  speaking  a  fortjign  tongue,  but  attacked  and 
replied  witli  great  fluency. 

During  six  months  after  his  return,  Jackson  visited 
daily  the  wards  of  LaPitie  under  the  charge  of  Louis  ; 
he  never  failed  to  go  there  in  the  afternoon,  after  hav- 
ing passed  sometimes  three  or  four  liours  in  the  usual 
morning  attendance.  Sometimes  this  afternoon  visit  con- 
tinued from  one  until  five  or  six  P.  M.  ;  often  did  he  re- 
main until  long  afttr  dark,  and  he  frequently  spent  one 
or  two  hours  in  endeavoring  to  learn  fully  the  history  of 
one  patient.  Nothing  restrained  him ;  the  elements 
had  no  influence  over  his  spirit  on  these  occasions  ;  but 
onward  he  pursued  his  career — always  hoping,  always 
animated  by  a  holy  love  of  his  profession,  and  an  eager 
desire  of  coming  at  truti).  We  often  thought  he  exert- 
ed himself  too  much,  but  he  smiled  at  our  fears  1 
well  remember  one  afternoon,  about  five  P.  M.  that  after 
having  already  made  two  visits  he  started  again  for  La 
PiMe,  after  having  attended  Andral's  lecture  at  the  School 
of  JVIedicine.  1  accompanied  him.  His  step  was  elastic 
and  full  of  buoyancy,  but  his  cheek  was  pale  and  his 
countenance  thin.  He  passed  rapidly  through  our  often 
trod  paths  and  when  near  the  great  entrance  gate  of  La 
Pitic,  he  suddenly  exclaimed,"  If  I  did  not  feel  so  vve!l 
I  should  think  I  had  a  pleurisy,  so  severe  a  pain  is  there 
at  this  moment  in  my  side.*'  He  however  made  his 
visit 

We  often  walked  together  in    the    Garden  of  Plants 
and  in  the  vicinity  of  Paris,  and  on  these  occasions  our 


OF    JAMES    JACKSON,   JR.  211 

conversations  were  mostly  upon  medical  topics,  but  very 
frequently  they  were  upon  other  subjects,  "  When  1 
meet  a  stranger  I  always  shmo  my  colors,''  said  he  to 
me  on  one  of  these  occasions.  "  T  tell  hitn  all  I  feel 
and  thus  I  persuade  a  man  to  open  his  heart  to  me  — 
and  in  this  way  I  have  gained  many  sincere  friends, 
whilst  youj  by  pursuing  an  opposite  course,  have  not. 
How  much  pleasure  have  I  enjoyed  which  you  have  ne- 
ver felt!"  His  remark  reminds  me  of  two  great  pecu- 
liarities of  his  mind.  I  allude  first,  to  his  power  of 
winninof  the  confidence  of  those  connected  with  him 
so  far  as  to  learn  their  sentiments  upon  almost  every 
subject,  and  second,  to  his  frank  manner  of  telling  his 
friends  their  faults.  A  young  gentleman  of  great  talent 
was  residinar  near  him  while  in  Paris,  and  mv  friend 
was  much  annoyed  at  the  waste  of  opportunities  which 
this  gentleman  was  guilty  of.  At  length  he  spoke  very 
plainly  to  him,  and  I  was  very  mucli  amused  at  the 
naivete  of  the  young  man  as  he  related  the  interview 
he  had  just  had  with  Jackson.  "  I  never  was  so  severely 
scolded  in  my  life  as  I  was  last  evening  by  your  friend 
Jackson.  He  told  me  that  I  ought  to  be  ashamed  of 
wasting  my  time,  talents  and  opportunitj'  as  I  was  doing 
and  that  I  ought  to  be  up  and  studying  something.  I  al- 
most felt  inclined  to  be  angry,  but  in  truth  I  could  not, 
for  everything  he  said  was  expressed  in  such  words, 
that  1  found  it  impossible  to  be  provoked." 

If  to  any  one  the  beautiful  epithet  of  the  ancients, 
" pius"  could  be  applied,  I  know  of  no  individual  more 
worthy  of  it  than  Jackson.  No  one  I  ever  knew,  reve- 
renco('  his  parents  as  he  did  His  heart  seemed  too  full 
of  deep  feelings  when  speaking  of  his  fcither;   he  could 

* 


212  REMINISCENCES. 

not  express  them.  "  If  there  be  any  one  thing  truly 
delightful  to  me,"  said  he  one  day  when  we  were  stroll- 
ing in  the  Garden  of  Plants,  ''  it  is  this  :  I  feel  as  if 
since  my  arrival  in  Europe  I  have  done  all,  ay,  more 
even  than  my  father  ever  hoped  I  would  do.  I  have 
given  him  much  true  pleasure  1  am  sure  from  the  kind 
letters  1  receive  from  him  daily."  It  was  quite  wonder- 
ful and  delightful  to  see  how  this  intense  love  of  his 
father  influenced  every  action  of  his  life.  Often  did  he 
say  ''  I  did  not  so  because  I  knew  my  father  would  not 

wish  me  to  do  it."     Again  ;  "  Come,  ,  and  hear   a 

part  of  the  delicious  letter  I  received  today  from  my 
father."  The  slightest  hint  from  his  parent  was  enough 
to  create  intense  pleasure  or  pain  in  his  bosom.  I  re- 
member perfectly  his  strong  expression  in  relation  to  a 
letter  received  in  answer  to  his  request  to  be  allowed  to 
visit  Germany.  The  father  expressed  regret  at  the  idea 
that  his  sojourn  in  Europe  would  be  lengthened.  Jack- 
son's eyes  glistened  when  he  said  to  me  —  "  I  seized 
my  pen  and  wrote  back  immediately  to  my  father,  tell- 
ing him  I  was  on  my  knees,  imploring  him  to  forget 
my  request." 

He  many  times  spoke  of  the  pleasure  he  experienced 
whenever  Andral,the  greatest  Professor  of  the  Medical 
School  in  Paris,  coincided  in  the  views  advanced  by  his 
father  in  relation  to  certain  points  in  medicine. 

Walking  one  day  through  the  yard  of  La  Pitie  togeth- 
er, we  met  one  of  the  sisters  of  charity  who  was  a  nurse 
of  the  hospital.  Her  face  was  beaming  with  mildness. 
"  There,"  said  he,  "  is  a  face  I  dearly  love  to  look  upon. 
I  watched  the  bearer  of  it  durincf  the  fearful  times  of 
the  cholera;   I  saw  her  devotion  to  the  dying  and  the 


OF    JAMES    JACKSON,  JR.  213 

dead,  and  now  I  dearly  Jove  to  look  upon  her,  for  by 
doing  so  I  am  always  reminded  of  home." 

These  strong  feelings  of  attachment  to  his  family,  his 
deep  sympatliy  in  their  joys  and  sorrows  sprang  too 
fretily  from  his  pure  heart  to  need  any  separation  from 
them  to  have  them  heightened.  xMost  j  ersons  are  not 
fully  sensible  of  the  blessed  joys  of  home  until  separat- 
ed from  them.  Jackson,!  am  sure,  always  felt  most 
sincerely  the  holy  relation  of  a  child  to  a  parent,  of  a 
brother  to  a  sister.  But  though  it  was  not  necessary  U  r 
him  to  leave  his  father's  hearth  in  order  to  learn  to 
value  it,  still  he  did  have  his  affectionate  feelings  excited 
in  the  strongest  degree  by  this  separation  and  by  the 
union  which  he  formed  with  the  gified  minds  and  sym- 
pathising hearts  he  met  in  Europe,  but  he  always  looked 
homeward  as  to  his  place  of  joy  and  of  ultimate  rest. 

" ,"    said  he  to  me  one  day  when  on  one  of  our 

accustomed  walks  in  the   environs    of  Paris,  " ,    if 

there  is  one  circumstance  I  hope  for  more  than  all  else, 
it  is  that  I  may  be  allowed  to  die  at  home  among  my 
own  family."  God  be  praised,  his  wish  was  graated. 
The  hands  of  those  dearest  to  him  ministered  to  him  in 
his  last  hour,  and  from  society  arose  the  voice  of  weep- 
ing as  his  light  went  out. 

While  in  Paris  I  never  heard  any  one  who  did  not 
speak  kindly  of  him  j  he  won  all  hearts  The  patients 
of  the  hospitaV  whom  he  visited  twice  a  day  loved  him 
very  much  He  spoke  kindly  to  them,  and  if  any  were 
in  distress,  hid  purse  was  like  his  heart,  open  for  their 
relief.  Many  pleasant  questions  were  asked  about  the 
"  jeune  Americain,"  when  I  returned  from  England 
afler  Jackson's  return  home.     How  attentive,  too,  was 


ft- 


214  REMINISCENCES 

lie  to  all  of  lis  during  illness  !  — or  when  in  anxiety  Iiow 
full  of  sympathy  !  how  expressive  his  eye  and  his  words 
of  kindness  !  I  could  appeal  lo  some  and  they  would 
tell  nie  how  well  Jackson  understood  the  proper  mode 
of  giving  consolation  to  them  in  suspense  or  deep  grief. 
He  possessed  much  of  that  quality  which  Mrs  Sigourney 
describes  as  almost  a  peculiar  attribute  of  woman, 
"  the  very  poetry  of  tenderness,  breathing  not  speaking 
a  knowledge  both  when  to  be  silent  and  when  to  speak." 
1  delight  in  dwelling  upon  this  part  of  the  character  of 
Jackson,  for  I  think  it  useful.  VVe  are  too  apt  to  decry 
this  exquisite  sensibility  ;  we  think  it  incompatible  with 
highly  intellectual  merit,  but  Jackson  is  a  noble  refuta- 
tion of  this  assertion. 

As  love  and  respect  for  the  Deity  are  nearly  connected 
with  holy  feelings  towards  man,  I  shall  now  speak  of 
Jackson's  religious  sentiments. 

Deep  and  holy  was  his    love    of  the    Deity    and  right 
reverently  did  he  worship  him.     His   was  no  time  serv- 
ing worship:  it  was  a  continual  stream  of  gratitude. — 
During  the  first  yrar  he  spent  in  Paris  he  was  a  regular 
attendant  upon  the  Unitarian  Church,  under   the  direc- 
tion of  an  Engli.'^h  Dissenter.     About  this  time  he  spent 
certain  hours  in  writing  commentaries  upon    the    bible. 
This  chuich    ceased  just  before    his  return  from    En- 
gland.    But  is  it  necessary  to  be  at  church  in  order  to 
feel  one's  heart  glow  with  gratitude  for  God's  goodness  ? 
Oh  no!  Jackson  never  had  a  day  [)ass   without   feeling 
his  reliance  upon  iheal!  vvise  and  benevolent  Deity  who 
rules  all.     Speaking  to  me  one  day   he    said,   "  I   have 
tried  much  not  to  do  so  ;    I  have  made  it   often  iu    the 
mc:r-ing  the  subject  of  prayer  to  the  Deity."     He  used 


OF    JAMES    JACKSON,  JR.  215 

to  say  he  was  first  led  to  think  seriously  and  act  from 
principle  by  the  perusal  of  Milton's  Paradise  Lost  while 
in  college.  When  in  Paris  we  both  attended  the  lectures 
of  the  eloquent  Jouffroy  f  and  from  him  he  learned  more 
fully  to  analyse  his  own  mind,  and  to  see  in  what  happi- 
ness consists  in  this  world,  and  the  next.  He  made  up 
his  determination  to  strive  in  this  lower  world  to  fit  him- 
self for  a  future  one,  that  would  be  purer  and  grander,  by 
cultivating  to  the  utmost  his  intellect  and  his  affections. 
,  I  cannot  pass  over  his  ardent  love  of  the  beauties  of 
nature.  When  travelling  among  the  Highlands  of  Scot- 
land, and  he  had  reached  the  shores  of  Loch  Katrine,  he 
was  very  much  excited.  I  fear  some  would  have 
thought  him  too  warm  in  his  enthusiasm  when  they 
know  that  after  having  remained  some  time  at  this  spot 
which,  bv  its  own  native  beauiies  and  the  poetry  of 
Scott,  has  become  a  shrine  to  which  many  pilgrims  bend 
their  steps,  he  left  it,  and  passed  over  the  surrounding 
mountains,  but  the  desire  for  return  was  so  great,  that 
suddenly  he  began  to  retrace  his  steps,  and  again  sought 
the  far-famed  place  in  order  to  gather  in  a  now  store  of 
those  holy  influences  which  Nature  sheds  upon  any 
true  lover  of  her  beauties,  at  the  foot  of  Loch  Katrine. 
The  return  of  Jackson  would  be  called  extravagance 
by  many,  nay,  downright  folly ;  but  no :  it  was  a 
hio-h  and  ennobling  love  of  nature  ;  it  was  natural  reli- 
gion that  brought  him  once  more  back  to  this  fair  spot 
of  God's  earth,  in  order  to  offer  with  more  fervent  feel- 
ings his  prayers  to  the  God  of  Nature.     Smile  not,  then, 

*  See  Note  -2. 


216  REMINISCENCES 

at  the  enthiisiasm  of  Jackson.     It  would  be  well  for  all 
of  us,  if  we  could  like  him, 

•'  Find  tongues  in  trees  —  books  in  tiie  running  brooks  — 
Sermons  in  stones,  and  good  in  everything." 

" ,"  said  he  to  me  when  I  was  speaking  of  my 

intended  journey  into  England  and  Scotland  ;  *'  Go  to 
Loch  Katrine,  it  is  worth  everything  else  you  will  find 
in  Great  Britain."  He  wore  always,  when  in  Paris,  a 
breast-pin  composed  of  two  stones  gathered,  as  he  told 
me,  from  the  two  spots  which  had  interested  him  the 
most  deeply  —  Mont  Blanc,  and  Trenton  Falls  in 
America.  From  nature  he  drew  consolation  and  sup- 
port. The  opening  flower  excited  in  his  glowing 
heart  sweet  and  kind  thoughts  which  he  brought  back 
into  the  world  in  his  intercourse  with  it.  From  the 
massive  and  sublime  scenery  of  our  own  country  and  of 
Switzerland,  lie  gained  vast  conceptions  of  the  Deity. 
He  was  then  a  true  lover  of  nature.  He  proved  in  his 
own  person  thnt  a  deep,  holy,  even  a  romantic  love  of 
it,  is  not  inconsistent  with  the  perfect  fulfilment  of 
all  the  duties  incumbent  upon  him  as  member  of  society, 
and  of  the  highest  intellectual  acquirements. 

Allied  to  the  love  of  Nature  is  that  of  the  fine  arts. 
Jackson  could  almost  worship  a  Madonna  of  Raphael; 
and  his  sense  of  the  beautiful  in  music  was  exquisite. 
There  are  some  who  knew  how  much  he  depended 
upon  music  for  his  recreation  in  Paris.  The  sad  and 
soul-subduing  air  of  Weber's  last  thoughts  when  played 
with  taste  would  make  his  tears  flow. 

But  perhaps  it  will  be  allowable  for  me  to  hint  at  what 
he  gained  in  his  profession  during  his  sojourn  in  Paris, 


OF    JAMES    JACKSON,    JR.  217 

and  especially  during  tlie  last  six  months  of  his  slay. 
A  gentleman  who  has  been  long  in  the  profession,  one 
who  is  highly  respected  by  his  brethren  and  the  com- 
munity at  large,  said  to  me  one  day  —  '•  I  know  of  no 
person  who  is  his  (Jackson's)  equal  in  the  diagnosis  of 
disease,  and  I  make  no  exceptions  either  from  among 
the  young  or  old,  when  I  say  that  James  Jackson  knows 
more  about  disease  than  any  man  in  the  community.' 
This  may  seem  extravagant,  but  he  who  made  the 
remark,  knows  too  well  the  criterion  by  which  medical 
merit  is  to  be  judged  of,  to  make  a  mistake.  I  fearlessly 
say,  Jackson  had  gained  powers  of  recognising  diseases 
in  their  early  stages,  wliich  were  wonderful.  I  have 
been  eye  witness  of  one  case,  at  least,  in  which  he  dis- 
cerned commencing  consumption  before  Louis  did.  He 
attended  much  to  auscultation  and  percussion,  and 
pointed  out  important  circumstances  to  be  attended  to  in 
their  application  to  diseases  of  the  lungs.  One  of  these, 
Louis  mentioned  several  times  during  the  course  of 
clinical  lectures  delivered  by  him  during  the  winter 
after  the  departure  of  Jackson;  he  always  alluded  to 
our  friend  as  the  one  who  first  pointed  it  out. 

At  length  the  hour  for  his  leaving  Paris  arrived.  It 
was  one  of  deep  feeling  for  many.  He  had  already 
taken  leave  of  his  well  loved  instructor,  being  satisfied 
he  could  not  do  so  at  the  last  moment.  Few  friends 
were  with  him  as  he  was  too  much  overcome  by  their  ap- 
proach. He  felt  that  he  was  leaving,  perhaps  forever,  the 
spot  where  he  had  passed  many  happy,  profitable  hours  ; 
he  had  seen  for  the  last  time,  one  who  had  been  to  him 
as  a  dear  father,  when  separated  from  his  parents  and 
family  ;  he   had  set  his  eyes  for  the  last  time   upon  the 


21S  REMINISCENCES 

friend  who  fiad  pointed  out  to  liini  witii  tender  interest 
a  high  and  noble  way  of  pursuing  what  Jackson  es- 
teemed the  noblest  of  all  professions,  and  who  had 
breathed  into  his  soul  that  same  ardent  love  of  truth 
which  animated  himself;  he  had  parted  from  his  "  sec- 
ond father."  Tlius  terminated  the  intercourse  of  Jack- 
son with  Louis.  I  met  Louis  in  1834,  soon  after  the 
news  of  Jackson's  death  had  reached  him.  The  worthy 
professor's  voice  choked  as  he  spoke  of  his  young  friend, 
the  "  poor  young  man."  He  could  hardly  utter  the 
words  "poor  Jackson."  His  tenderness  of  manner 
towards  me  as  friend  of  his  friend  1  shall  long  remember. 
"  Adieu,  my  dear,"  said  he,  "  and  yet  I  dislike  to  say 
the  word,  for  perhaps  we  shall  never  see  each  other 
again." 

Jackson  took  his  way  towards  England,  in  order  to 
make  his  farewell  visit  upon  his  beloved  friends  of 
Great   Britain. 

He  sailed,  and  arrived  in  happiness  and  health,  and 
in  the  bosom  of  his  family,  he  drank  his  cup  of  joyous- 
ness.  I  saw  a  letter  written  soon  after  his  return. 
Every  word  teemed  with  dear  affection  towards  his 
father  and  his  family;  beautifully  simple  were  his  ex- 
pressions, and  full  of  pure,  almost  child-like  delight. 

Not  many  weeks  after  his  return,  having  been 
intensely  occupied  in  his  profession, —  he  fell  ill  with 
fever,  and  I  doubt  whether  he  did  not  receive  then  his 
death  blow.  But  he  recovered,  in  some  measure,  and 
on  his  convalescence,  he  wrote  me  pirt  of  a  letter, 
which  afterwards  was  sent  unfinished  as  he  had  left  it. 
1  give  below  the  translation  of  most  of  it,  leavinor  out 
merely  a  few  sentences,  which  would  be  uninteresting 
to  a  general  reader.     It  was  written  in  French. 


OF    JAMES    JACKSON,    JR.  219 

"  Boston,  Febbuahy  27,  1334. 


MY    DEAR 


Do  you  wish  me  to  commence  with  excuses  for  not 
having  written  to  you  previously  ?  No,  1  am  sure  that 
your  kind  feelings  towards  me  are  so  great  that  you 
will  readily  excuse  me,  as  I  have  recently  been  ill.  I  have 
just  received  yours  of  January  4,  and  for  it  1  return  you 
many  thanks  although  it  is  written  in  a  barbarous  tongue 
instead  of  the  beautiful  French  you  still  have  the  hap- 
piness of  speaking.  I  have  received  likewise  two  more 
letters  from  you.  One  of  them  1  did  not  see  for  some 
days,  as  at  the  time  of  its  arrival  my  health  did  not  allow 
of  my  reading;  in  fact  I  could  not  have  understood  your 
pathological  morsels.  I  thank  you  most  sincerely,  and 
I  thank  all  my  Paris  friends  for  the  kind  sentiments  they 
had  toward  me  during  my  illness.     I    shall  never  forget 

the  interest  they  have  taken  in  me.     But,  my   dear  

you  cannot  conceive  of  the  extreme  debility  of  one  af- 
fected with  typhus  fever,  nor  of  the  delirium  which 
brings  up  before  the  mind  reminiscences  the  most 
strange  and  inconsistent,  the  weakness  of  intellect  which 
comes  on  after  convalescence,  which  excites  in  the  pa- 
tient a  fear  that  he  will  never  be  able  to  pursue  his  pro- 
fession. 1  will  tell  you  something  of  all  these  if  you 
would  like  to  have  me  do  so.  After  spending  a  month 
(during  the  prevalence  ol"  typhus)  and  having  observed 
many  cases  of  the  disease;  after  I  had  made  examina- 
tions of  eight  or  ten  bodies,  and  two  days   after  having 

watched  with  young ■  I  began  to    feel    rather  ill. 

At  first  I  had  pain  in  the  head  on  rising  in  the  morning, 
with  a  little  vertigo.  The  day  on  which  these  symp- 
toms first  appeared,  I  made  two  examinations,  one  of 
typhus   the  other  of  cancer.     I  found    that  1  was  much 


220 


REMINISCENCES 


more  fatigued  than  usual,  and  I  suffered  very  much 
from  pain  in  the  back.  On  the  same  or  the  next  day  I 
lost  completely  my  appc^tile,  »  *  *  I  experienced  much 
debility  and  an  indisposition  to  undertake  my  usual  occu- 
pations. This  was  2'vd  of  October,  and  in  the  evening 
the  pains  were  still  more  eevere.  I  thought  immedi- 
ately of  typhus,  but  I  was  unwilling  to  believe  that  1 
was  about  to  liave  that  affection.  That  night  I  passed 
most  wretchedly,  in  terrible  dreams  and  great  restless- 
ness, &c.  For  three  days  I  was  very  nearly  in  the  same 
state,  always  out  and  about  my  various  engagements  and 
yet  in  doubt  whether  1  was  going  to  be  really  ill.  In 
fact  as  it  seemed  to  me,  until  the  2Gth,  and  even  on  the 
morning  of  that  day  my  symptoms  seemed  to  decrease. 
I  breakfasted  with  a  tolerable  appetite  and  afterwards 
went  to  the  hospital,  but  after  spending  a  half  hour  there 
I  felt  too  ill  to  finish  the  visit.  I  returned  home.  *  * 
In  the  evening  1  found  my  pulse  accelerated,  my  skin 
hot.  1  no  longer  doubted,  and  my  father  had  already 
become  satisfied  that  the  disease  was  typhus  fever. 
Here  I  was,  fully  taken  with  a  disease,  the  many  sad 
cases  of  which  I  had  seen  in  Paris,  I  did  not  then 
forget  1  assure  you.  Towards  evening  of  the  next  day 
I  begged  my  father  to  bleed  me,  and  he  did  so  to  eigh- 
teen ounces.  From  that  moment,  of  more  than  three 
weeks  I  have  lost  entirely  all  recollection  ;  my  weak- 
ness increased  daily,  so  that  very  soon  the  attendants 
were  obliged  to  lift  mo  from  one  bed  to  another  and  to 
turn  me  from  one  side  to  the  other ;  I  could  do  nothing  for 
myself.  I  had  alternately  delirium  and  stupor.  1  dreamt 
of  everything.  Frequently  I  was  at  Paris;  and  was  mak- 
ing a  visit  at  La  Pitic.     1  was  dining    with  M.  Louis  at 


OF    JAMES    JACKSON,    JR.  221 

the  Palais  Royal,  or  was  walking  with  him  through 
the  streets  of  Paris.  One  night  1  exclaimed,  it  is 
all  over,  I  shall  die  tomorrow.  Almost  the  last  circum- 
stance I  remember  clearly  was  that  1  was  suffering  from 
very  severe  pain,  so  intense  that  I  thought  I  was  going 

to  die  instantly  ;  I  shrieked  aloud,  and   begged  

who  watched  with  me  to  call  my  father,  after  having 
given  me  some  laudanum.  My  father  soon  appeared  and 
I  observed  on  his  countenance  an  expression  such  as  I 
had  never  seen  it  bear  before  and  may  the  good  God 
grant  that  I  may  never  see  it  again.  I  immediately  per- 
ceived his  suspicions.  He  seized  my  arm;  my  pulse 
was  not  more  accelerated  than  it  had  been  on  the  evening 
previous.  He  gave  me  this  information  and  immediately 
his  features  began  to  resume  their  natural  expression. 
Except  during  this  night  I  never  suffered  anything  but 
very  trivial  pains,  until  my  appetite  began  to  return  very 
gradually  about  one  month  from  the  beginning  of  the 
attack ;  then  1  began  to  wish  for  food,  and  I  had 
pains  in  the  limbs  which  almost  made  me  shriek  aloud. 
The  spots  were  very  abundant,  rose  colored  and  of  an 
elliptical  shape  over  the  whole  body  ;  I  had  two  crops 
of  sudamina  —  more  copious  than  I  had  ever  seen  be- 
fore. The  last  one  was  at  tlie  time  of  convalescence,  so 
that  I  was  able  to  enjoy  the  sight  of  them.  During  the 
few  days  at  the  commencement  of  the  disease  whilst  I 
possessed  my  reasoning  powers,  I  told  my  father  I 
experienced  a  troublesome  sensation  in  the  abdomen,  in- 
dicating for  myself  that  the  seat  of  the  disease  was 
there.  It  was  a  kind  of  pleasure  to  know  by  actual 
sensation  the  truth  of  what  has  been  discovered  by  our 
honored  master,  and  the  proof  of  which  rests  upon  ex- 
ternal evidence. 


222  REMINISCENCES 

But  if  you  cannot  understand  the  misfortune  of  being 
entirely  dependent  upon  others,  of  being  incapable  of 
making  any  efforts  for  yourself,  of  being  deprived  at 
the  same  moment  of  the  use  of  mind,  of  muscles,  and 
of  internal  organs,  of  everything  in  fact  which  com- 
poses the  physical  and  moral  being;  of  being  placed 
upon  the  back  during  three  or  four  weeks  without  being 
able  to  turn  from  one  side  to  the  other,  dying  with  thirst 
without  having  the  ability  to  procure  water,  and  suf- 
fering a  thousand  little  inconveniences  from  continuing 
too  long  in  one  position,  &c. ;  neither  do  you  know  the 
delights  one  experiences  from  the  constant  and  unwea- 
ried kindness  of  friends  to  us  while  ill ;  the  pleasure  of 
observing  one's  self  watched  with  anxiety  by  those 
from  whom  one  has  no  right  to  expect  such  friendship  ; 
of  finding  those  to  be  our  true  friends  whom  we  thought 
to  be  mere  acquaintances  ;  neither  can  you  have  any  idea 
of  the  paradise  produced  by  a  few  flowers  in  the  sick 
chamber,  or  by  a  little  daylight,  or  by  new  faces  after 
one  has  been  deprived  for  some  time  of  the  light  of  day, 
of  the  company  of  friends  and  of  everything  which  this 
world  produces,  which  is  so  full  of  interesting  objects. 
I  am  sure  that  it  must  rarely  happen  that  a  traveller  even 
in  Italy  can  be  so  much  excited  by  the  sightof  the  beau- 
tiful paintings  in  that  country  as  I  was  when  looking  at 
the  St  Bernard  dog  which  M.  Louis  had  presented  me. 
My  box  containing  it  arrived  during  my  convalescence 
and  my  happiness  was  almost  too  much. 

Have    the    goodness,   my    dear  ,   to    express    to 

the  society  my  thanks  for  the  interest  it  feels  in  me.  I 
am  well  pleased  that  it  goes  on  prosperously,  for  I  am 
convinced  that  it  is  the  bestof  schools,  and  that  M.Louis 
would  do  a  great  service  to  the  world  if  he  could  collect 


OF    JAMES    JACKSON,    JR.  223 

in   it  young    men  from   every  civilized  country    of  all 

quarti^rs  of  the  globe.     You  tell  me   that   is   quite 

well,  but  I  should  doubt  much  whether  he  is  entirely 
out  of  danger.  Please  write  to  me  more  particularly 
about  his  health, 

I  shall  tell  you  nothing  about  what  I  discovered  in  re- 
lation to  the  fever  patients  of  our  city,  for  I  shall  write  all 
to  M.  Louis;  in  fact  I  should  not  have  delayed  so  long 
writing  to  him  had  I  not  expected  to  receive  a  letter 
from  him,  but  perhaps  he  has  written  to  me,  though 
I  have  never  received  anything. 

I  will  now  tell  of  a  case  which  I  know  will  be  inter- 
esting to  you,  and  ifyou  wish  you    may    read  it  to   the 

society.     You    doubtless  remember the    carpenter, 

aged  about  35,  who  was  at  our  hospital  many  times,  who 
had  his  left  side  contracied  and  an  aperture  communi- 
cating with  the  cavity  of  the  chest  near  the  edge  of  the 
ribs" 


Here  the  letter  abruptly  closes  and  probably  Jackson 
did  not  write  much  afterwards,  as  six  days  from  that  time 
his  last  illness  came  on. 

He  had  just  met  all  his  friends  around  his  father's 
table  to  congratulate  him  on  his  happy  return  to  health. 
The  finger  of  God  pressed  upon  him  even  at  that  hour 
of  hope  and  rejoicing  ;  and  he  soon  died. 

Thus  did  this  pure,  and  generous  spirit  take  leave 
of  us.  And  who  was  there  among  the  community  who 
did  not  feel  the  loss  society  had  sustained  ?  The  ways 
of  Providence  aie  inscrutable;  sometimes  almost  in- 
comprehensible. So  it  seems  to  many  that  the  death  of 
our   friend   is.     He  had  just  entered   upon  the  active 


224  REMINISCENCES. 

duties  of  a  noble  profession,  well  prepared  for  the  prac- 
tice of  it  by  the  great  acquirements  gained  wliile  in 
Europe.  He  brougijt  to  this  dear  object  of  his  life,  his 
whole  soul,  burning  as  it  was  with  a  love  of  truth.  But 
he  had  a  nobler  aim  than  eminence  in  his  profession. 
Jackson's  feelings  were  too  elevated  to  be  satisfied  with 
merely  earthly  ambition.  His  object  was  to  ennoble  his 
own  nature;  or,  I  should  say,  he  felt  most  deeply  the 
nobleness  of  man's  nature,  and  he  was  satisfied  that  we 
are  placed  here  for  intellectual  and  moral  improvement, 
and  he  therefore  strove,  by  the  cultivation  of  his  intel- 
lect and  of  his  affections,  to  gain  this  end. 

Jackson  was  one  to  lead  mankind,  not  to  follow  its 
dictates.  And  why  was  he  taken  away  if  thus  able  to 
direct  mankind  ?  He  knows  little  of  human  nature, 
who  is  not  sensible  how  much  good,  nay,  absolute 
happiness,  is  produced  by  God,  even  in  his  most  dread- 
ful decrees.  How  many  are  led  to  think  more  seriously 
upon  the  high  destiny  awaiting  them,  if  they  be  true  to 
themselves.* 

Regarding  man  as  placed  in  the  world  for  his  own  self- 
development,  Jackson  was  ready  to  leave  us.  His  was 
an  early  growth,  but  it  was  a  rich  one  ;  and  he  has  left 
behind  a  pure,  a  noble  example  for  his  friends,  his  young 
associates  in  medicine  to  look  to.  Long  will  his  mem- 
ory live  with  those  who  knew  him,  even  when  they 
have  ceased  to  weep  at  the  mention  of  his  name. 
His  zeal  will  recur  to  them  in  every  act  of  their  lives ; 
and  in  the  hour  of  sickness  and  of  trial,  his  kindness  of 
heart,  and  powers  of  giving  consolation  will  come  up 
before  them  like  the  visions  of  past  joys,  "  sweet  though 
mournful  to  the  soul." 

♦  Sec  Note  1 


NOTES. 


Note  1. 

1  cannot  forbear  publishing  the  following,  which  was 
written  by  the  same  friend  who  penned  the  character  of 
James  published  in  the  Daily  Advertiser  (page  99).  He 
has  gone  now  to  assert  his  "  claim  to  the  friendship  of 
Jackson  in  heaven."  The  death  of  this  young  man  was 
as  striking  and  mournful  as  that  of  my  friend.  iNay,  for 
some  reasons  it  was  more  deeply  touching.  Some  one 
will  ere  long  I  trust  portray  before  us,  his  fellow  pilgrims, 
the  beauties  and  energies  of  his  fair  character.  I  would 
merely  state  that  having  been  failing  in  strength  for  some 
weeks,  he  by  medical  advice  went  to  visit  his  friends  in 
New  York.  Arrived  there,  he  was  not  improved,  though 
he  did  not  suffer,  but  his  strength  diminished  daily.  One 
day  he  rode  out  with  his  mother ;  he  returned, 
"  And  sinking  —  passed  away." 

Concord,  June  17. 
Dear  Sir  —  Dr  Jackson  has  been  so  kind  as  to  send 
me  the  memoir  and  letters  of  James.     I  could  not  have 
believed  that  the  book  would  give  me  the  feeling  1  have 


226  NOTES. 

had  while  reading  it.  I  am  ashamed  to  confess  that  it 
has  enlaiged  my  idea  of  the  character  of  my  friend. 
To  be  sure,  I  had  no  means  of  judging  of  liis  professional 
attainments;  but  I  ought  not  to  have  suffered  the  trans- 
parent simplicity  and  candor  of  his  mind  to  have  de- 
ceived me  as  to  its  depth.  My  only  excuse  is  that  as 
Goethe,  I  be  lieve,  said  of  his  friend  Schiller,  "  he  grew 
go  fast,  he  strode  forward  with  such  rapidity  that  if  you 
failed  to  see  him  f<)r  a  little  while,  you  were  surprised 
to  find  how  far  advanced  he  was  beyond  the  ground  on 
which  you  had  expected  to  meet  him."* 

Especially  is  the  religious  tone  of  his  letteis  different 
from  what  I  had  supposed.  The  recognition  of  God  is 
more  constant  and  distinct.  From  what  he  himself  said 
when  he  told  me  that  he  had  been  wholly  absorbed  in 
other  studies,  that  beyond  iiis  conviction  of  moral  obli- 
gation all  his  faith  was  yet  to  be  formed,  that  he  wanted 
to  study  religion  as  a  science; — I  foolishly  supposed, 
his  thoughts  had  been  unexercised  about  the  relation  of 
man  to  God.  I  did  not  enough  allow  for  his  singular 
modesty  and  frankness,  nor  for  the  rigorous  discipline 
which  he  was  wont  to  prescribe  to  himself  in  any  study. 
1  now  see  that  he  was  impatient  of  lingering  amongst 
the  first  principles  of  the  Christian  faith,  and  desired 
intimately  to  know  and  receive  it. 

Do  not  misunderstand  me.  I  did  not  imagine  him 
irreligious;  but  I  thought  his  religion  was  more  uncon- 
scious, that  like  the  sunlight  of  his  beautiful  temper   it 

*  The  quotation  above  given  is  not  exactly  correct.  "  He  strode 
farward  with  awful  rapidity.  If  1  was  a  week  without  seeing 
him,  wlioa  we  met  [  was  astounded  and  knew  not  where  to  lay 
hold  of  him,  I  found  him  so  much  farther  advanced." — OoUke's 
C(fnDCrsations  with  Felix  Mendelsonhe. 


NOTES.  227 

was  more  a  "  life  of  God  in  his  soul"  than   anything 
that  had  been  with  him  the  subject  of  reflection. 

I  am  glad,  very  glad,  this  book  has  been  made.  Such 
a  monument  was  owed  to  him  ;  and  to  all  of  us  who 
are  consoled  by  it  and  instructed  what  manner  of  per- 
sons we  must  be  if  we  would  assert  our  claim  to  his 
friendship  in  heaven. 

Very  sincerely, 

Your  friend  and  servant, 

Chas.  C.  Emersox. 

The  above  letter  was  the  first  one  I  ever  received  from 
Emerson,  and  it  was  written  in  consequence  of  an  argu- 
ment we  had  held  in  relation  to  the  character  of  Jackson, 
during  which  I  stated  that  I  did  not  think  my  friend's 
most  important  qualities  were  appreciated  by  the  com- 
munity —  that  he  had  grown  vastly  in  consequence  of 
his  sojourn  in  Europe,  and  that  he  had  had  no  opportu- 
nity of  showing  the  capabilities  of  his  spirit.  Emerson 
did  not  agree  to  this  assertion,  and  like  almost  every  one 
else  was  delighted  and  at  the  same  time  surprised  when 
the  memoir  appeared. 

Note  2. 

Theodore  JoufFroy  is  at  present  about  forty  years  of 
age,  and  is  Assistant  Professor  of  Modern  Philosophy  at 
the  Sorbonnein  Paris.  He  believes  all  forms  of  religion 
to  be  developments  in  the  human  mind  of  that  principle 
which  exists  in  all  and  teaches  men  to  look  for  something 
better,  holier,  grander  than  can  ever  be  found  in  this  world. 
Christianity  he  regards  as  the  most  perfect  form  ever  yet 


22S  NOTES. 

exhibited  to  the  world.     He  is  a  man  of  great  eloquence. 
His  language  and   manner  are  beautifully  simple.     His 
powers  of  reasoning   are    very   acute  —  his   arguments 
well  planned.     I  never  shall  forget  his  lecture  on  the  Im- 
mortality of  the  Soul.    It  was,  at  that  time,  like  balm  to 
my  spirit.     With  in  two  years  he  has  been  appointed  to 
a  professorship  in  the  College  of  France,  and  is  becom- 
ing every  day  more  popular  with  the  young  French  stu- 
dents.    They  crowd  his  lecture    room.     They  are  inter- 
ested in  his  discussions  on  the  most  sublime  topics  of  re- 
ligion and  morals.     They   talk    of  them  afterwards.    I 
consider  France  as  in  the  process  of  regeneration.    The 
country  underwent  a  total  overthrow  of  all  religion  du- 
ring the  horrors  of  the  revolution,  but  no  w  it  is  reviving. 
Religion  is  natural  to  man,  and  France  led  on  by  her  phi- 
losophers, will  ere  long  stand  in  the  foremost  rank  as  a 
supporter  of  Christianity.     By  Christianity  I  mean  not 
any  opinion  of  a  sect,  but  the  development  of  the  princi- 
ples of  Christ  which  for  eighteen   hundred  years  have 
made  so  small  advances  compared  with  what  they  are 
destined  to  make,  and  will  make  when  they  are  rightly 
understood. 


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